[Monitoring of heart function in the treatment with cardiotoxic cytostatic drugs].
It is the purpose of this paper to show the concept of noninvasive assessment of cardiomyopathy (CM) in cytostatic treatment, esp. with daunorubicin A (A). Our follow-up study during therapy with A shows 255 patients, examined by ECG, by systolic time intervals (STI)-PEP/LVET (normal value less than or equal to 0.44) and PEPI (normal value less than or equal to 148 ms) by echocardiography (UCG) with measurement of shortening fraction (SF), normal value less than or equal to 30% and in 6 cases by microcatheter with exercise test.


RESULTS
(1) ECG does not predict CM. (2) 23 patients (8%) had abnormal SF in UCG, 6 patients of these having no symptoms of cardiac failure. These patients were examined by microcatheter, all 6 having abnormal values during exercise. So all patients with abnormal SF had objective signs of latent or over CM. (3) PEP/LVET was abnormal in all patients with CM, but false positive in 22% of all investigations, mostly by shortening of LVET. PEPI, abnormal in all patients with CM, was false positive only in 8.8. UCG is the most specific noninvasive method for assessment of CM in cytostatic treatment. STI are less specific, but highly sensitive to CM and therefore a useful screening method. PEPI gives the highest specificity, allowing a better selection than PEP/LVET. STI in contrast to UCG can easily be obtained outside cardiologic centers, ie., in the oncologic department itself. UCG by cardiologic units are needed only about 10-15% of investigations. If all values are abnormal, cardiotoxic treatment should be stopped, even when patients are asymptomatic.
D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis; D003630:Daunorubicin / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography; D006334:Heart Function Tests; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans
D004317:Doxorubicin; D003630:Daunorubicin
Uberwachung der Herzfunktion bei der Behandlung mit kardiotoxisch wirkenden Zytostatika.