title: Does left ventricular diastolic function deteriorate earlier than left ventricular systolic function in anthracycline cardiotoxicity?
abstract: Cardiotoxicity is the most important complication in patients receiving anthracycline chemotherapy. We studied the left ventricular diastolic function (LVDF) and systolic function (LVSF) in these patients and assessed whether LVDF deteriorates earlier than LVSF. We prospectively studied 58 patients (mean age 48.02 ± 13.87; 32 female, 26 male) on anthracycline treatment, before chemotherapy (S0) and after cumulative doses of 139 ± 12 mg/m(2) (S1) and 308 ± 14 mg/m(2) (S2). The LVSF was computed in terms of left ventricular ejection fraction (LVEF) from equilibrium radionuclide angiography (ERNA). The peak ejection rate (PER), peak filling rate (PFR), time to peak ejection rate (TPER), time to peak filling rate (TPFR), 1/3rd filling fraction and ratio of PFR and PER were calculated from ERNA and were also standardized using 150 baseline ERNA studies. Statistical analysis was done by repeated measures analysis of variance (ANOVA). We found significant decrease in LVEF (P<0.001) and PER (P<0.001) between the S1 and S2 studies and PFR (P<0.007) between the S0 and S1 studies. In conclusion in patients receiving anthracycline treatment, LVDF deteriorates earlier than left ventricular systolic function (LVSF).
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi-110029, India. chetantruptipatel@hotmail.com
authors.forename: Chetan D
authors.initials: CD
authors.lastname: Patel
authors.forename: Vijay Babu
authors.initials: VB
authors.lastname: Balakrishnan
authors.forename: Lalit
authors.initials: L
authors.lastname: Kumar
authors.forename: Niraj
authors.initials: N
authors.lastname: Naswa
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D000704:Analysis of Variance; D018943:Anthracyclines / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D054715:Cardiotoxins / Q000009:adverse effects; D017023:Coronary Angiography; D003971:Diastole / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects / Q000502:physiology*; D013997:Time Factors; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018943:Anthracyclines; D000900:Anti-Bacterial Agents; D054715:Cardiotoxins