Ventricular late potentials: another expression of cardiotoxicity of cytostatic drugs in children?
With the aim of finding a sensitive method to detect early anthracycline-induced myocardial damage ultimately resulting in cardiomyopathy, we studied the occurrence of ventricular late potentials, using a signal averaged electrocardiogram, in 68 children with cancer during or after chemotherapy. Ten (15%) of the children showed late potentials; in addition, patients treated with cytostatic drugs had significantly lower voltages of the last 40 ms of the QRS complex (RMS40) and a longer duration of low amplitude signals in the terminal QRS (LAS) than control patients. The occurrence of late potentials was not significantly correlated with anthracycline therapy or dosage, nor with the presence of echocardiographic abnormalities; in none of the patients we found late potentials during therapy with anthracyclines. We therefore conclude that late potentials are not helpful for early detection of myocardial injury. The occurrence of late potentials, however, does show another expression of cardiotoxicity not specifically related to anthracycline therapy. The occurrence of these late potentials may have prognostic significance with regard to the risk of ventricular arrhythmias during longer follow-up of these patients.
Tamminga
R Y
RY
Department of Paediatrics, University Hospital Groningen, Netherlands.
Bink-Boelkens
M T
MT
Kievit
J
J
D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography / Q000592:standards*; D005069:Evaluation Studies as Topic; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted
D000903:Antibiotics, Antineoplastic