title: Monitoring left ventricular function in adults receiving anthracycline-containing chemotherapy.
abstract: OBJECTIVE
  To assess prospectively (1) the incidence of early anthracycline-induced cardiotoxicity; (2) the best predictor for identifying individuals at risk of developing functional cardiotoxicity; and (3) the most sensitive standard echocardiographic measure for the detection of anthracycline-induced changes in left ventricular (LV) function.
  
  
  METHODS
  Sixty-seven consecutive patients (45 male, mean age 50+/-18 years) requiring doxorubicin-containing chemotherapy were enrolled. Clinical and echocardiographic assessments occurred before they received any anthracycline, after low-dose anthracyclines and 1-3 months after completion of their chemotherapy.
  
  
  RESULTS
  Twenty six percent of patients without significant pre-existing cardiac disease developed cardiotoxicity. The parameter that best predicted the development of functional cardiotoxicity was the change in EF between baseline and low dose with an area under the curve of 0.92. The Tei index detected declines in LV function earlier in the course of treatment with anthracyclines and to a greater significance than any other standard echocardiographic measurement but did not predict functional cardiotoxicity.
  
  
  CONCLUSIONS
  All patients receiving potential cardiotoxic chemotherapy should be under the care of a cardiologist and have their EF monitored closely.
authors.affiliation: Department of Cardiology, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom. markbelham@zoom.co.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Belham
authors.forename: Anton
authors.initials: A
authors.lastname: Kruger
authors.forename: Sophie
authors.initials: S
authors.lastname: Mepham
authors.forename: Giorgio
authors.initials: G
authors.lastname: Faganello
authors.forename: Colin
authors.initials: C
authors.lastname: Pritchard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000009:adverse effects / Q000494:pharmacology*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents