Women with breast cancer who recieved the angiotensin-receptor blocker candesartan had no reduction in the heart’s pumping function following adjuvant cancer therapy, whereas the betablocker metoprolol prevented an increase in markers of heart damage. Geeta Gulatis‘s PhD thesis is based on the PRADA study from Akershus University Hospital.


  1. Candesartan protects against early decline in systolic heart function following adjuvant anthracycline-containing breast cancer therapy
  2. Metoprolol prevents an increase in markers of heart damage during breast cancer therapy
  3. Neither candesartan nor metoprolol prevents increased cardiac fibrosis following anthracycline therapy.


Thesis: Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy
Candidate: Geeta Gulati
Time: April 25, 2018 at 13:15
Place: Akershus University Hospital: Large Auditorium
Link to university website (in Norwegian)


(1) The PRADA study includes 120 otherwise healthy women who were treated for breast cancer between 2011 and 2014. The women were randomized to four groups, that in addition to anthracyclines received either candesartan (a blood pressure drug), metropolol (a betablocker), both drugs or placebo

(2) The researchers used cardiac MRI to look at global left ventricular function, and found the systolic function to be reduced after completion of anthracycline therapy. However, those who received candesartan did not have any decline in heart function.

(3) In 69 of the women, Gulati and coworkers also measured the extracellular volume of the hearts, an indication of edema and/or stiffening of the heart (fibrosis). The extracellular volume increased in a dose-dependent manner during the 13 weeks of anthracycline therapy. Neither metoprolol nor candesartan prevented this increase.

(4) The levels of several markers of heart damage increased following adjuvant breast cancer therapy. Larger increases were however not associated with a larger decrease in heart function. Metoprolol protected against the increase in troponins, whereas candesartan did not have any effect.


(1) Heck, S. L., Gulati, G., Ree, A. H., Schulz-Menger, J., Gravdehaug, B., Røsjø, H., Steine, K., Bratland, Å., Hoffman, P., Geisler, J., & Omland, T. (2012). Rationale and design of the prevention of cardiac dysfunction during an Adjuvant Breast Cancer Therapy (PRADA) TrialCardiology123(4), 240-247.

(2) Gulati, G., Heck, S. L., Ree, A. H., Hoffmann, P., Schulz-Menger, J., Fagerland, M. W., Gravdehaug, B., von Knobelsdorff-Brenkenhoff, F., Bratland, Å., Storås, T. H., Hagve, T-A., Røsjø, H., Steine, K., Geisler, J. & Omland, T. (2016). Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2× 2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprololEuropean heart journal37(21), 1671-1680.

(3) Gulati, G., Heck, S. L., Røsjø, H., Ree, A. H., Hoffmann, P., Hagve, T. A., Norseth, J., Gravdehaug, B., Steine, J., Geisler, J., & Omland, T. (2017). Neurohormonal Blockade and Circulating Cardiovascular Biomarkers During Anthracycline Therapy in Breast Cancer Patients: Results From the PRADA (Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy) StudyJournal of the American Heart Association6(11), e006513.

(4) Heck, S. L., Gulati, G., Hoffmann, P., von Knobelsdorff-Brenkenhoff, F., Storås, T. H., Ree, A. H., Gravdehaug, B., Røsjø, H., Steine, K., Geisler, J., Schulz-Menger, J., & Omland, T. (2017). Effect of candesartan and metoprolol on myocardial tissue composition during anthracycline treatment: the PRADA trialEuropean Heart Journal-Cardiovascular Imaging.

Latest News

May 28, 2024

Photos from the workshop on Advancing Ischemic Heart Disease Research

Approximately 25 researchers met in Trondheim for the new workshop called “Advancing Ischemic Heart Disease…

Read more
May 14, 2024

Photos from Course in Cardiac Mechanics 2024

Cardiac researchers and clinical cardiologists need to know key concepts and terms for measuring and describing…

Read more
April 28, 2024

Professor Kristina H. Haugaa receives the 2024 Heart Research Award

The Norwegian Health Association has awarded the prestigious 2024 Heart Research Award (Hjerteforskningsprisen) to professor Kristina…

Read more
September 08, 2023

Annual Symposium 2023: Winners and photos

More than 100 participants attended the 21st Annual Norwegian Symposium on Heart Research, hosted by…

Read more
Norheart uses cookies for analytical purposes, content and ads customisation, and to further develop our services.
Learn more
Show again