{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:12:57Z","timestamp":1791231177395,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Breast cancer (BC) is the most prevalent cancer globally, with a significant mortality rate, especially among women. While advances in treatment have reduced BC mortality, cardiovascular complications resulting from anticancer therapies have become a major concern. The autonomic nervous system (ANS) may be affected in BC patients and it is assessed with heart rate variability (HRV). The aim of this study was to investigate the prevalence of impaired HRV, its predictors, and its clinical impacts in BC patients. Materials and Methods: We retrospectively screened all female BC patients and enrolled cases who underwent 24 h Holter electrocardiography monitoring with accessible clinical follow-up data. Results: This study included 136 BC patients, and the mean age was 56.8 \u00b1 10.8 years old. Impaired HRV was present in 36.8% of patients, and hypertension was identified as a significant predictor of reduced HRV (OR = 3.61, CI: 1.01\u201312.92, p = 0.048). Furthermore, de novo atrial fibrillation (AF) occurred more frequently in patients with impaired HRV (20% vs. 8.1%; p = 0.044). None of the HRV parameters were associated with all-cause mortality, and cancer stage was found to be the only independent predictor of all-cause mortality (HR = 3.93, CI: 1.81\u20138.55; p &lt; 0.001). Conclusions: HRV is impaired in a significant proportion of patients with BC. Hypertension plays a crucial role in the deterioration of HRV in patients with BC, and de novo AF is more common in patients with impaired HRV. However, HRV does not appear to predict all-cause mortality in patients with BC. This study highlights the importance of the optimal management of cardiovascular risk factors, such as hypertension, to prevent ANS dysfunction in cancer patients.<\/jats:p>","DOI":"10.3390\/medicina61040608","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T06:45:51Z","timestamp":1743144351000},"page":"608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictors and Clinical Impacts of Impaired Heart Rate Variability in Women with Breast Cancer"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-7681","authenticated-orcid":false,"given":"\u0130mran","family":"Ceren","sequence":"first","affiliation":[{"name":"Department of Cardiology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7823-3878","authenticated-orcid":false,"given":"Beyza Nur","family":"\u00c7itir Durmu\u015fo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Ziya","family":"\u015eener","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcenter, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9895-1132","authenticated-orcid":false,"given":"Fadime","family":"Bozduman Habip","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-0512","authenticated-orcid":false,"given":"Sedat","family":"K\u00f6ro\u011flu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Kahramanmara\u015f Sutcu Imam University, 46050 Kahramanmara\u015f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Necla","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zt\u00fcrk","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Ero\u011flu B\u00fcy\u00fck\u00f6ner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Acibadem University, 34638 \u0130stanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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