title: Anthracycline-induced cardiotoxicity: cardiac monitoring by continuous wave-Doppler ultrasound cardiac output monitoring and correlation to echocardiography.
abstract: BACKGROUND
  Anthracyclines are agents with a wellknown cardiotoxicity. The study sought to evaluate the hemodynamic response to an anthracycline using realtime continuous-wave (CW)-Doppler ultrasound cardiac output monitoring (USCOM) and echocardiography in combination with serum biomarkers.
  
  
  METHODS
  50 patients (26 male, 24 female, median age 59 years) suffering from various types of cancer received an anthracycline-based regimen. Patients' responses were measured at different time points (T0 prior to infusion, T1 6 h post infusion, T2 after 1 day, T3 after 7 days, and T4 after 3 months) with CW-Doppler ultrasound (T0-T4) and echocardiography (T1, T4) for hemodynamic parameters such as stroke volume (SV; SVUSCOM ml) and ejection fraction (EF; EFechocardiography%) and with NT-pro-BNP and hs-Troponin T (T0-T4).
  
  
  RESULTS
  During the 3-month observation period, the relative decrease in the EF determined by echocardiography was -2.1% (▵T0-T4, T0 71 ± 7.8%, T4 69.5 ± 7%, p = 0.04), whereas the decrease in SV observed using CW-Doppler was -6.5% (▵T0-T4, T0 54 ± 19.2 ml, T4 50.5 ± 20.6 ml, p = 0.14). The kinetics for serum biomarkers were inversely correlated.
  
  
  CONCLUSIONS
  Combining real-time CW-Doppler USCOM and serum biomarkers is feasible for monitoring the immediate and chronic hemodynamic changes during an anthracycline-based regimen; the results obtained were comparable to those from echocardiography.
authors.affiliation: Medical Department III, Ludwig-Maximilians University of Munich, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Geiger
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: Patricia
authors.initials: P
authors.lastname: Suhl
authors.forename: Petra
authors.initials: P
authors.lastname: Stieber
authors.forename: Veronika
authors.initials: V
authors.lastname: Lange
authors.forename: Dorothee
authors.initials: D
authors.lastname: Baur
authors.forename: Andreas
authors.initials: A
authors.lastname: Hausmann
authors.forename: Johanna
authors.initials: J
authors.lastname: Tischer
authors.forename: Sophia
authors.initials: S
authors.lastname: Horster
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D010865:Pilot Projects; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging*
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic