Cardiac status in bone tumor survivors up to nearly 19 years after treatment with doxorubicin: a longitudinal study.
BACKGROUND
Longitudinal assessment of cardiac toxicity in anthracycline-treated long-term bone tumor survivors.


METHODS
Cardiac status was assessed in 29 patients 14.1 (range 7-18.7) years after treatment with doxorubicin (DOXO) 360 mg/m(2) (median 225-550). The median age of the patients at the time of the study was 32.5 years (range 19.7-52). The evaluation consisted of an electrocardiogram (ECG), 24-hr ambulatory ECG with analysis of heart rate variability (HRV) and echocardiography. The results were compared to those of a study of the same patients that was performed 5 years earlier 8.9 years (range 2.3-14.1) after treatment. [Postma et al.: Med Pediatr Oncol 26:230-237, 1996]


RESULTS
We found no progression of ECG abnormalities, arrhythmias, or echocardiographic abnormalities. Females were at risk for reduced contractility (P = 0.006). HRV was significantly reduced compared to age- and sex-matched controls and compared to the previous results.


CONCLUSIONS
Anthracycline-related late echocardiographic abnormalities and arrhythmias detected 8.9 years after treatment, showed no further deterioration with ongoing follow-up. However, there was a significant reduction of HRV. This suggests that HRV might be a sensitive test for detection of anthracycline-induced cardiac toxicity.
Department of Pediatrics, Division of Pediatric Oncology/Hematology, University of Groningen/University Hospital, Groningen, The Netherlands. a.postma@bkk.azg.nl
A
A
Postma
N J
NJ
Elzenga
J
J
Haaksma
M J M
MJ
Schasfoort-Van Leeuwen
W A
WA
Kamps
M Th E
MT
Bink-Boelkens
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy*; D002648:Child; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D012107:Research Design; D017741:Survivors
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin