title: Evaluation of ventricular function by echocardiography and radionuclide angiography in patients treated with mitoxantrone.
abstract: Mitoxantrone, an anthracenedione derivative structurally similar to anthracycline, was tested in 25 Phase II patients with advanced breast cancer, previously treated with different cycles of 5-fluorouracil. Cardiac toxicity was evaluated by means of electrocardiography, echocardiography and radionuclide left-ventricular ejection fraction. Ten patients received a cumulative dose less than 70 mg/m2 (median 33.6, range 28-63) and 15 a dose equal to or more than 70 mg/m2 (median 81, range 70-84). ECG abnormalities in the form of dysrhythmias and ST-T changes were observed in 41% of the patients. Echocardiographic myocardial function parameters recorded in 10 of the 15 patients who received more than 70 mg/m2 demonstrated a trend to deterioration, whereas the nuclear angiographic ejection fraction recorded in all 15 patients who had more than 70 mg/m2 had significantly decreased. No patients developed congestive heart failure but almost one-quarter of them had a fall in myocardial function parameters of more than 15% compared to pretreatment values. These data indicate that mitoxantrone has a significant toxic effect on myocardial cells also at cumulative doses of less than 85 mg/m2 which is generally considered beyond the limit of safety for patients without risk factors.
authors.affiliation: Cardiorespiratory Physiopathology Division, National Institute for the Study and Cure of Tumours, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Villani
authors.forename: M
authors.initials: M
authors.lastname: Galimberti
authors.forename: F
authors.initials: F
authors.lastname: Crippa
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy*; D004341:Drug Evaluation; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects* / Q000627:therapeutic use; D011875:Radionuclide Angiography
chemical_list: D008942:Mitoxantrone