[Anthracycline-induced cardiotoxicity: cardiac MRI after treatment for childhood cancer].
OBJECTIVE
Quantification of left and right ventricular function using MRI in young cancer patients treated with cardiotoxic anthracyclines.


METHODS
Twenty-eight patients (mean age 16.4 years) underwent cardiac MRI at 1.5 T. The study protocol consisted of morphologic T2-weighted images with fat suppression and cine steady-state free precession sequences (SSFP) for functional analysis. Seven patients were examined at the end of chemotherapy, two of them also repeatedly during therapy, and 21 patients following an average period of three years after finishing chemotherapy (range one month--20 years)


RESULTS
The end-systolic volume index increased and the ejection fraction of the left and right ventricle decreased during anthracycline therapy. Two of seven patients showed a myocardial edema at the end of the therapy. In 15 of all 28 patients, the left ventricular ejection fraction was reduced to less than 55 % (minimum 44 %). No clinical signs of cardiac insufficiency or cardiomyopathy were observed.


CONCLUSIONS
MRI is able to detect acute as well as chronic subclinical cardiotoxic effects of anthracyclines. Impairment of the right ventricular function should be considered in the diagnosis of anthracycline-induced cardiomyopathy.
Oberholzer
K
K
Klinik und Poliklinik für Radiologie, Johannes-Gutenberg-Universität Mainz. oberholz@radiologie.klinik.uni-mainz.de
Kunz
R P
RP
Dittrich
M
M
Thelen
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis*; D002648:Child; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D013318:Stroke Volume; D013997:Time Factors; D016276:Ventricular Function; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
D018943:Anthracyclines