Assessment of early epirubicin cardiotoxicity in women with breast cancer.
BACKGROUND
Anthracycline-containing chemotherapy has been the most frequently observed cause of iatrogenic cardiac damage in patients with breast cancer. The purpose of this study was to evaluate by radionuclide ventriculography whether a mean cumulative dose of epirubicin (MCDE) induced left ventricular (LV) systolic or/and diastolic dysfunction in 32 patients treated for breast cancer.


METHODS
Thirty-two patients with breast cancer according to chemotherapeutical trials received MCDE of 360 m/m2. All patients were studied before and after they completed chemotherapy with radionuclide ventriculography at rest. Systolic and diastolic left ventricular parameters were assessed.


RESULTS
Diastolic left ventricular parameters and R-R intervals significantly differed before and after completed chemotherapy in our patients: peak filling rate (PFR: 2.8 +/- 0.6 vs. 2.2 +/- 0.7 EDV/sec) and time to filling rate (TPFR: 182 +/- 48 vs. 2.25 +/- 50 msec), R-R: 723 +/- 51 vs. 620 +/- 45 msec, p < 0.01. Ejection fraction, as a systolic parameter/did not significantly differ before and after completed chemotherapy (EF: 59 +/- 7 vs. 58 +/- 6%), p > 0.05.


CONCLUSIONS
Our results indicate that left ventricular diastolic dysfunction even at an MCDE of 360 mg/m2 may be an early sign of epirubicin cardiotoxicity.
Sobić-Saranović
D
D
Institute of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Yugoslavia.
Pavlović
S
S
Susnjar
S
S
Neskovi c-Konstantinović
Z
Z
Jelić
S
S
D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003971:Diastole / Q000187:drug effects; D015251:Epirubicin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013599:Systole / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin