Project details


Female diastolic cardiac function: a primary care study among long term breast cancer survivors and their controls [copy]

breast cancer Cardiac function clinical epidemiology

Prof. dr. G.H. de Bock
P. van der Meer
drs D. Brandenbarg

Type of project:
Stage Wetenschap / Researchproject of MD/PhD programme

Nature of the research:
Analysis of already collected data of a primary care cross-sectional cohort study consisting of data on 700 women (corona proof)

Fields of study:
GP medicine oncology cardiology

Background / introduction
Effective breast cancer (BC) treatment typically requires chemotherapy, radiotherapy, or both. However, these therapies may be associated with long-term cardiac dysfunction. At the department of General Practice, we performed a cross-sectional study (BLOC: Breast cancer Long-term Outcome of Cardiac function)1, in which we included 350 survivors of breast cancer treated with chemo and/or radiotherapy at least 5 years prior to measurements, and 350 women without a history of cancer. Echocardiography was performed among all women. We showed that BC survivors were at increased risk of mild systolic cardiac dysfunction (LVEF<54%) compared to women without a history of cancer.

However, age-specific left-ventricular diastolic dysfunction (LVDD) was high in both groups, 43% in BC survivors and 40% in the reference population. With diastolic dysfunction there is resistance to the filling of the ventricle due to inadequate relaxation or decreased compliance. Diastolic dysfunction is often mistaken for systolic dysfunction, although it may require different treatment. For general practitioners it is important to know which women are at risk for diastolic dysfunction, and may need to be monitored or treated accordingly.
Research question / problem definition
Which (risk) factors are associated with diastolic cardiac dysfunction in women, and is treatment for BC among these risk factors?
The student will start with a (systematic) literature search on risk factors for on diastolic dysfunction among women. After that, the student will analyze data collected among the 700 women included in the BLOC study. In this study, we collected data on cardiac risk factors such as hypertension, dyslipedima, diabetes, and BMI. We also assessed lifestyle factors such as smoking behavior, physical activity, measured blood serum levels of NT-proBNP, and assessed fatigue, anxiety, and depression. For the 350 women with a history if BC, we obtained detailed information on the received treatment.

The aim is for the student to write an international research paper, with the option to apply for a MD/PhD trajectory. In this trajectory, we will reexamine the women who participated in the BLOC study. This will be performed in close collaboration with the departments of epidemiology, cardiology, medical oncology and radiation oncology.
Boerman L. M., Maass S. W. M. C., van der Meer P., Gietema J. A., Maduro J. H., Hummel Y. M., Berger M. Y., de Bock G. H., Berendsen A. J. (2017) Long-term outcome of cardiac function in a population based cohort of breast cancer survivors: A cross-sectional study. Eur.J.Cancer. 81, 56-65.
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