[Evaluation of adriamycin cardiotoxicity using equilibrium radionuclide ventriculography. II. Results during exercise].
The aim of the study was to evaluate the influence of a cardiotoxic therapy with Adriamycin (ADM) on left ventricular pump function. In 348 patients with malignant tumors, 606 equilibrium radionuclide ventriculographies (ERNV) were performed. In 90 patients, resting studies (R-ERNV) were followed by studies during exercise (E-ERNV). Results were evaluated statistically to determine whether E-ERNV provides more reliable parameters in the early detection of Adriamycin cardiomyopathy (ADM-CMP) than R-ERNV. The following left ventricular parameters were evaluated: global ejection fraction (gEF); end diastolic, end systolic, stroke volume (EDV, ESV, SV); peak filling rate, peak ejection rate (pFR, pER); time to peak filling rate (TpFR) and heart rate. Increasing ADM doses yielded a significant decrease (p less than 0.05) of resting values of gEF, pER, pFR. In contrast, stress-induced increases of gEF, pER, pFR were found independent of accumulative ADM doses and independent of the resting values of these parameters. An increase of gEF resulted from a significant decrease of ESV. In most cases, pathologic results at rest were detected earlier than subnormal changes of exercise values. Therefore, E-ERNV does not have a significantly higher sensitivity in the early detection of ADM-CMP than R-ERNV and is not required for the surveillance of patients under ADM therapy.
Nuklearmedizinische Abteilung der Radiologischen Klinik, Universität München, BRD.
P
P
Knesewitsch
N H
NH
Göldel
S
S
Fritsch
E
E
Moser
D000328:Adult; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D004912:Erythrocytes; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000187:drug effects*; D006334:Heart Function Tests; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D005082:Physical Exertion; D011877:Radionuclide Imaging; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate; D014003:Tin Polyphosphates
D014003:Tin Polyphosphates; C017742:technetium Tc 99m stannous pyrophosphate; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium; D004317:Doxorubicin
Beurteilung der Adriamycin-Kardiotoxizität mittels der Aquilibrium-Radionuklid-Ventrikulographie. II. Ergenbnisse unter körperlicher Belastung.