[Endomyocardial biopsy in the monitoring of treatment with anthracyclines. Value of the assay of lactate dehydrogenase and its isoenzymes].
Determination of intramyocardial lactate dehydrogenase (LDH) and its isoenzymes (LDH 1 to 5) has been conducted on biopsy material obtained from the right ventricle in 18 patients who had received the theoretical maximal dose of anthracyclines. Total LDH activity, expressed in mU/mg of myocardial protein is higher (852.61 +/- 87.98) than in subjects with good left ventricular function (334 +/- 208), p less than 0.02. The activity of LDH 1 is decreased in the treated group, whereas that of LDH 3,4 and 5 is raised: LDH 1 = 41.95 +/- 7.25 per cent instead of 47.76 +/- 7.93 per cent (p less than 0.03); LDH 3 = 15.34 +/- 5.09 per cent instead of 9.18 +/- 4.56 per cent (p less than 0.05). The H/M ratio (H = fractions of heart isoenzymes; M = fractions of muscle isoenzymes of LDH) is decreased in the treated group: H/M = 4.06 +/- 1.13 instead of 5.30 +/- 1.80 (p less than 0.01). When the histological lesions are minimal (stage 1 or 1.5 of Billingham), the H/M ratio is not altered: 4.92 +/- 1.02. When the lesions attain or exceed stage 2, the H/M ratio is significantly decreased: 3.74 +/- 0.82. These results, which indicate an increase in anaerobic metabolism, add quantitative information to the histological study.
Ferrière
M
M
Donnadio
D
D
Michel
F
F
Descomps
C
C
Latour
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001706:Biopsy; D005260:Female; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology*; D009279:Naphthacenes / Q000009:adverse effects
D000903:Antibiotics, Antineoplastic; D007527:Isoenzymes; D009279:Naphthacenes; D007770:L-Lactate Dehydrogenase
La biopsie endomyocardique dans la surveillance des traitements par anthracyclines. Intérêt du dosage de la lacticodéshydrogénase et de ses isoenzymes.