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The effect of anthracycline chemotherapy on reducing left ventricular ejection fraction in breast cancer patients at Putri Bidadari Hospital Stabat

  • Adi Rizka ,
  • Anna Millizia ,
  • Hendra Wahyuni ,
  • Hayatul Farziani ,
  • Khairunnisa Syahril ,


Link of Video abstract:


Introduction: Breast cancer is the most common cancer and also the leading cause of death from cancer in women. Anthracycline chemotherapy is one of the most effective chemotherapy agents and is often used in the treatment of breast cancer. However, its use can cause cardiotoxicity which is characterized by a decrease in LVEF. Regulation of the Minister of Health of the Republic of Indonesia states that breast cancer patients who receive anthracycline chemotherapy must have an echocardiography examination after 2 cycles. This study aimed to assess the effect of anthracycline chemotherapy on reducing LVEF in breast cancer patients.

Methods: This study was an observational study with a cross-sectional design. The data used was secondary data in the form of LVEF values of breast cancer patients before being given anthracycline dose chemotherapy with 60 mg/m2 of body surface area (BSA), after being given 2 cycles and after 4 cycles with a total of 22 respondents. Data were analyzed using the Paired T-test. The limitations of this study were small sample size (22 patients) and study was limited to only one hospital.

Results: The results of this study obtained p values for LVEF 1-LVEF 2 of 0.748 and LVEF 2-LVEF 3 of 0.215 with an average decrease in LVEF of 0.318% for LVEF 1-LVEF 2 and 1.409% for LVEF 2 and LVEF 3 with p value 0.000 and 0.001.

Conclusion: Based on the results of this study it is known that there are differences in LVEF values before and after administration of chemotherapy but there are no significant differences and cannot be classified as cardiotoxicity so that echocardiographic examinations in patients in close proximity are not effective enough to detect anthracycline-induced cardiotoxicity.


  1. WHO. Breast Cancer [Internet]. World Health Organization. 2021 [cited 2023 Apr 11]. Available from:
  2. Kemenkes RI. Prevalensi Kanker Payudara di Indonesia [Internet]. Kementerian Kesehatan Republik Indonesia. 2022 [cited 2023 Apr 11]. Available from:
  3. Lee K, Kang I, Mack WJ, Mortimer J, Sattler F, Salem G, et al. Feasibility of high intensity interval training in patients with breast Cancer undergoing anthracycline chemotherapy: A randomized pilot trial. BMC Cancer. 2019;19(1):1–10.
  4. Koric A, Chang C-P, Mark B, Rowe K, Snyder J, Dodson M, et al. Cardiovascular disease risk in long-term breast cancer survivors: A population-based cohort study. Cancer. 2022;128(14):2826–35.
  5. Menteri Kesehatan Republik Indonesia. KMK Nomor HK.01.07/MENKES/6485/2021. Formul Nas. 2021;1–167.
  6. Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019;6(2):19.
  7. Bocchi EA, Avila MS, Ayub-Ferreira SM. Aging, cardiotoxicity, and chemotherapy. Vol. 11, Aging. United States; 2019. p. 295–6.
  8. Yeh ETH, Vejpongsa P. Subclinical Cardiotoxicity Associated With Cancer Therapy: Early Detection and Future Directions. Vol. 65, Journal of the American College of Cardiology. United States; 2015. p. 2523–5.
  9. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(36):2768–801.
  10. Giantris A, Abdurrahman L, Hinkle A, Asselin B, Lipshultz SE. Anthracycline-induced cardiotoxicity in children and young adults. Crit Rev Oncol Hematol. 1997;27(1):53–68.
  11. Gerodias FR, Tan MK, De Guzman A, Bernan A, Locnen SA, Apostol-Alday A, et al. Anthracycline-induced cardiotoxicity in breast cancer patients: A five-year retrospective study in 10 centers. Cardiol Res. 2022;13(6):380–92.
  12. Rahmayani H. Pengaruh terapi antrasiklin terhadap perubahan fraksi ejeksi ventrikel kiri pada pasien kanker payudara yang menjalani kemoterapi. Universitas Gajah Mada; 2019.

How to Cite

Rizka, A., Millizia, A., Wahyuni, H., Farziani, H., & Syahril, K. (2024). The effect of anthracycline chemotherapy on reducing left ventricular ejection fraction in breast cancer patients at Putri Bidadari Hospital Stabat. Bali Medical Journal, 13(1), 463–466.




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