Early detection of anthracycline-induced cardiotoxicity by stress radionuclide cineangiography in conjunction with Fourier amplitude and phase analysis.
Thirty-three cases of anthracycline related cardiotoxicity occurred in our institution in patients with a previously negative cardiovascular history, physical examination, and normal ECG. A total of 95 RNCA studies were performed in this group (73 studies included both rest and exercise RNCA). Twenty-one patients had two or more serial studies. Seventeen had a normal, baseline prechemotherapy study and 16 had studies done following the initiation of therapy. Fourier analysis, consisting of amplitude and phase images, were created for each study. In the subset with a baseline study, the rest LVEF became abnormal first in two of 17 patients (12%), the rest or stress LVEF in ten of 17 (59%), the rest Fourier image analysis in ten of 17 (59%), and the rest or stress Fourier image analysis in 16 of 17 (94%). In the subset without a baseline study, the rest LVEF was abnormal in ten of 16 (63%), the rest or stress LVEF in 15 of 16, (94%), the rest Fourier image analysis in 16 of 16 (100%), and the rest or stress Fourier image analysis in 16 of 16 (100%). The authors conclude that: 1) the exercise RNCA is superior to the rest RNCA alone in the early detection of anthracycline related cardiotoxicity, 2) the single most sensitive indicator of cardiotoxicity is Fourier image analysis; and 3) sequential rest and stress RNCA studies with Fourier amplitude and phase analysis is the most sensitive, noninvasive method of evaluating patients who receive potentially cardiotoxic agents.
Alcan
K E
KE
Robeson
W
W
Graham
M C
MC
Palestro
C
C
Oliver
F H
FH
Benua
R S
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging; D003630:Daunorubicin / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects*; D004562:Electrocardiography; D015251:Epirubicin; D005260:Female; D005583:Fourier Analysis; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin; D004317:Doxorubicin; D013670:Sodium Pertechnetate Tc 99m; D003630:Daunorubicin