Association between comorbidity burden and subclinical cardiac dysfunction in cancer patients prior to chemotherapy

Background: Subclinical cardiac dysfunction is a growing concern in cancer patients receiving chemotherapy. Early detection before treatment initiation is crucial to prevent overt cardiotoxicity. Objective: This study evaluates the association between comorbidity burden and subclinical cardiac dysfunction, using echocardiographic parameters, in cancer patients prior to chemotherapy. Method: This retrospective observational study analysed 110 cancer patients who underwent transthoracic echocardiography before chemotherapy. Comorbidity burden was assessed using the Charlson Comorbidity Index (CCI) and Karnofsky Performance Status (KPS). Echocardiographic evaluation included Global Longitudinal Strain (GLS), the E/e[Formula: see text] ratio (early transmitral inflow velocity to early diastolic mitral annular velocity) and left atrial volume index (LAVI). Subclinical dysfunction was defined as [Formula: see text] and/or diastolic dysfunction. Spearman’s rank correlation and multivariable linear regression were performed. Results: Abnormal GLS ([Formula: see text]) was found in 68 patients (61.8%), while 42 patients (38.2%) had normal GLS values. Higher comorbidity burden (CCI) was modestly associated with worse GLS ([Formula: see text], [Formula: see text]) and higher E/e[Formula: see text] ([Formula: see text], [Formula: see text]), whereas better functional status (Karnofsky score) correlated with more preserved GLS ([Formula: see text], [Formula: see text]). Higher age was independently associated with higher E/e[Formula: see text] ([Formula: see text], 95% CI 0.005–0.065, [Formula: see text], [Formula: see text]), whereas the association between CCI and E/e[Formula: see text] was of borderline significance ([Formula: see text], 95% CI −0.024–0.396, [Formula: see text], [Formula: see text]). Conclusion: This study showed a significant correlation between comorbidity indices and GLS as well as diastolic function parameters. This suggests that comorbidity burden and functional status are significantly associated with subclinical cardiac abnormalities before chemotherapy.