乳腺癌的治疗可能对心脏造成负担，增加心力衰竭的风险。研究表明，超过一半的乳腺癌患者死于非肿瘤相关原因，心血管疾病(CVD)是导致死亡的主要原因。然而，乳腺癌预后与心力衰竭之间的潜在机制仍不清楚。为了调查这一问题，我们进行了一项分析，在早期和晚期乳腺癌中比较了与心力衰竭相关的基因与差异表达基因(DEGs)。这项分析发现18个基因同时存在于这两个状况中，其中15个与免疫功能有关。这表明免疫通路可能在乳腺癌患者的心力衰竭预后中起到一定作用。我们进一步利用1260名乳腺癌患者的基因表达数据，对这15个基因对患者的存活时间的影响进行了研究。此外，通过富集分析，我们还探索了与这些基因在乳腺癌和心力衰竭中相关的功能和途径。通过构建一个转换模型，我们发现这15个基因的表达模式能够准确预测心力衰竭的发生。该模型的AUC为0.86，AUPR为0.91。此外，通过分析接受PD-1治疗并出现心力衰竭的乳腺癌患者的单细胞测序数据，我们发现两种疾病之间存在大量的细胞特异性基因。这表明乳腺癌治疗后免疫细胞基因表达变化可能与心力衰竭的发展相关。版权所有 © 2023 Elsevier Ltd.

The treatment of breast cancer can potentially impose a burden on the heart, leading to an increased risk of heart failure. Studies have shown that more than half of breast cancer patients die from non-tumor-related causes, with cardiovascular disease (CVD) being the leading cause of death. However, the underlying mechanism linking breast cancer prognosis and heart failure remains unclear. To investigate this, we conducted an analysis where we compared the differentially expressed genes (DEGs) in early and advanced breast cancer with genes associated with heart failure. This analysis revealed 18 genes that overlapped between the two conditions, with 15 of them being related to immune function. This suggests that immune pathways may play a role in the prognosis of breast cancer patients with heart failure. Using gene expression data from 1260 breast cancer patients, we further examined the impact of these 15 genes on survival time. Additionally, through enrichment analysis, we explored the functions and pathways associated with these genes in relation to breast cancer and heart failure. By constructing a transformer model, we discovered that the expression patterns of these 15 genes can accurately predict the occurrence of heart failure. The model achieved an AUC of 0.86 and an AUPR of 0.91. Moreover, through analysis of single-cell sequencing data from breast cancer patients undergoing PD-1 treatment and experiencing heart failure, we identified a significant number of cell-type-specific genes that were shared between both diseases. This suggests that changes in gene expression in immune cells following breast cancer treatment may be associated with the development of heart failure.Copyright © 2023. Published by Elsevier Ltd.