Monitoring left ventricular function in adults receiving anthracycline-containing chemotherapy.
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.
Belham
Mark
M
Department of Cardiology, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom. markbelham@zoom.co.uk
Kruger
Anton
A
Mepham
Sophie
S
Faganello
Giorgio
G
Pritchard
Colin
C
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
D018943:Anthracyclines; D000970:Antineoplastic Agents