title: Tissue Doppler imaging and conventional echocardiography after anthracycline treatment in adults: early and late alterations of left ventricular function during a prospective study.
abstract: OBJECTIVE
  To evaluate the short and long-term effects of anthracycline chemotherapy in adults using conventional echocardiography and pulsed tissue Doppler imaging (TDI).
  
  
  RESULTS
  Twenty patients were included of which 16 had a complete follow up. They underwent an echocardiography before chemotherapy, 1-3 months and 3.5+/-0.6 years after the treatment. We recorded pulsed TDI at the mitral annulus, the basal segments of the left ventricular (LV) lateral and posterior walls; peak velocities in systole (Sm), early (Em) and late diastole and the isovolumic relaxation time (IVRT) were measured. The cumulative dose of doxorubicin was 211+/-82 g/m2. Early after anthracycline therapy, we observed changes in the diastolic LV function with a decrease of the mitral E peak velocity and TDI Em. At the late control, diastolic changes were more pronounced and associated with an alteration of the systolic function (LV ejection fraction and Sm). Four patients had a LV ejection fraction <50%; in these patients we observed a mitral annulus IVRT <80 ms at the early control; this could be of interest to predict later impairment of the LV ejection fraction.
  
  
  CONCLUSIONS
  We found early changes in LV diastolic function and observed that late impairment of the LV ejection fraction occurred frequently after anthracycline therapy, despite normal systolic LV function during the first months of follow-up.
authors.affiliation: Cardiology Department, CHU Reims, France. stassanmangina@chu-reims.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Tassan-Mangina
authors.forename: Daniela
authors.initials: D
authors.lastname: Codorean
authors.forename: Marie
authors.initials: M
authors.lastname: Metivier
authors.forename: Brigitte
authors.initials: B
authors.lastname: Costa
authors.forename: Chantal
authors.initials: C
authors.lastname: Himberlin
authors.forename: Christelle
authors.initials: C
authors.lastname: Jouannaud
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Blaise
authors.forename: Jacques
authors.initials: J
authors.lastname: Elaerts
authors.forename: Pierre
authors.initials: P
authors.lastname: Nazeyrollas
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018943:Anthracyclines / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007938:Leukemia / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging*
chemical_list: D018943:Anthracyclines