[Cardiotoxicity of anthracyclines].
The cardiotoxicity of the anthracyclines, of which doxorubicin is the leading drug, manifests itself in two ways: acutely, giving rise to temporary and usually benign phenomena, and chronically, giving rise to cardiac failure which is often irreversible. The risk of cardiomyopathy is related to the total dose of anthracycline administrated. The main risk factors are, age, previous cardiac disease and mediastinal radiotherapy. The prevention of cardiomyopathy is based on the respect of empirical guide lines (interruption of anthracyclines at "threshold" cumulative doses) and on methods of detection of infra-clinical disease. Myocardial angioscintigraphy which is easier to perform than myocardial biopsy and more sensitive and specific than echocardiography seems to be the investigation of choice. The main lines of research are aimed at improving our understanding of the mechanism of the cardiomyopathy, the institution of clinical trials to detect the first signs of toxicity of continuous infusions, the improvement of the standardisation and specificity of methods of detection, better definition of alarm thresholds and the development of new, less cardiotoxic, anthracyclines and cardioprotective agents.
D000208:Acute Disease; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000517:prevention & control / Q000628:therapy; D002908:Chronic Disease; D006331:Heart Diseases / Q000139:chemically induced*; D006801:Humans; D009279:Naphthacenes / Q000009:adverse effects; D012306:Risk; D013997:Time Factors
D000903:Antibiotics, Antineoplastic; D009279:Naphthacenes
La cardiotoxicité des anthracyclines.