[Usefulness of stress echocardiography for early diagnosis of anthracycline-induced cardiomyopathy].
BACKGROUND
Early evidence of drug induced cardiomyopathy is of great importance in oncological treatment, especially for application of Anthrazyklines. Stress echocar-diography (SE) has been proven to be of value in determining left ventricular function at rest and under stress. This study was performed to investigate the cardiac function under Anthrazykline-chemotherapy (aCT).


METHODS
Patients with malignant thoracic tumors and indication for aCT underwent pharmacological SE (infusion of increasing dobutamin-doses, 5 microgram/kg/bw in 3 minute-steps) before starting aCT. Left ventricular ejection fraction (LVEF) and wall motion were measured. If the tumor decreased and the patients underwent 4 or more cycles of CT, at the end of the last CT another SE investigation was performed.


RESULTS
30 patients (20 men, 15 women; mean age 52, range 28 - 71) were included and the data were compared. Before aCT the mean LVEF was 59 % at rest and 71 % at maximum load, no disturbances of wall motion could be observed. After the end of aCT (mean dose 408 mg, range 256 - 549; mean 4.4 cycles, range 4 - 7) the LVEF was 58 at rest and 68 at maximum load (not significant) and there were also no disturbances of motion.


CONCLUSIONS
SE is an alternative to echocardiography at rest in assessment of left ventricular function in patients receiving Anthrazykline-CT. With the doses applied no patient developed cardiomyopathy. So we consider SE a cost-effective method and safe for patients.
Herth
F
F
Thoraxklinik-Heidelberg gGmbH, Abteilung Innere Medizin-Onkologie. f@herth.net
Schulz
M R
MR
Manegold
C
C
Becker
H D
HD
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013599:Systole / Q000187:drug effects; D013899:Thoracic Neoplasms / Q000188:drug therapy*
D000903:Antibiotics, Antineoplastic; D004280:Dobutamine
Durchführbarkeit der Stressechokardiographie zur Früherkennung der Anthracyclin-induzierten Kardiomyopathie.