title: Acute cardiac functional and morphological changes after Anthracycline infusions in children.
abstract: The aim of this study was to describe the acute effects of anthracyclines on left ventricular systolic and diastolic function using different echocardiographic modalities. Thirteen children scheduled to receive anthracyclines were prospectively studied. They underwent complete 2-dimensional and Doppler echocardiographic evaluations, including tissue Doppler imaging, before the first dose and<2 hours after each of the first 3 doses of anthracyclines (dose range 30 to 75 mg/m2). After the first dose, increased end-diastolic wall thickness, decreased wall thickening, and a prolonged myocardial performance index were noted. Parameters of diastolic function changed significantly, with a lower mitral E wave, a decreased E/A ratio, and prolonged isovolumic relaxation time. Also, reduced longitudinal early diastolic myocardial velocity and myocardial velocity acceleration during isovolumic contraction as well as reduced peak longitudinal and radial systolic strain rate and strain were noted. All these parameters remained significantly lower after subsequent doses. After the second dose, significant changes in the shortening fraction and the ejection fraction compared with baseline became apparent. After the third dose, further deterioration in radial peak systolic strain was seen. In conclusion, low to moderate doses of anthracyclines acutely induce cardiac diastolic and systolic dysfunction.
authors.affiliation: Pediatric Cardiology Department, University Hospitals Leuven, Leuven, Belgium. javier.ganame@uz.kuleuven.ac.be
authors.forename: Javier
authors.initials: J
authors.lastname: Ganame
authors.forename: Piet
authors.initials: P
authors.lastname: Claus
authors.forename: Benedicte
authors.initials: B
authors.lastname: Eyskens
authors.forename: Anne
authors.initials: A
authors.lastname: Uyttebroeck
authors.forename: Marleen
authors.initials: M
authors.lastname: Renard
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.forename: Bart
authors.initials: B
authors.lastname: Bijnens
authors.forename: George R
authors.initials: GR
authors.lastname: Sutherland
authors.forename: Luc
authors.initials: L
authors.lastname: Mertens
mesh_terms: D000293:Adolescent; D018943:Anthracyclines / Q000008:administration & dosage*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001783:Blood Flow Velocity / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D003630:Daunorubicin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007262:Infusions, Intravenous; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012107:Research Design; D013318:Stroke Volume / Q000187:drug effects*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin; D015255:Idarubicin; D003630:Daunorubicin