title: Assessment of late anthracycline-induced cardiotoxicity by123I-mIBG cardiac scintigraphy in patients treated during childhood and adolescence.
abstract: The goal of this study was to evaluate late cardiotoxic effects of anthracyclines (ATC) by evaluating cardiac sympathetic activity in a cohort of asymptomatic patients previously treated with ATC for childhood cancers.
  
  
  
  We studied 89 asymptomatic patients previously treated with ATC with a normal echocardiogram (49 men and 40 women) and a control group of 40 healthy individuals (26 men and 14 women). Both groups underwent planar myocardial123I-meta-iodobenzylguanidine scintigraphy (123I-mIBG). From these images, the early and late heart-to-mediastinum (H/M) ratio and washout rate (WR) were assessed.
  
  
  
  The mean survival at the time of the123I-mIBG scintigraphy was 5.3 ± 3.4 years. Patients treated with ATC had a lower but clinical normal left ventricular ejection fraction (LVEF) compared to controls (60.44 ± 6.5 vs 64.1 ± 6.0%, P < 0.01). Both the late H/M ratio and WR were not able to discriminate ATC treated patients from controls. The cumulative ATC dose was the only independent predictor of the LVEF, explaining approximately 12% of the variation in LVEF (P = 0.01).
  
  
  
  Although the pathophysiology behind ATC cardiotoxicity is most likely multifactorial, myocardial sympathetic activity is not associated with a reduction in LVEF 5-years after completion of chemotherapy.
authors.affiliation: Department of Nuclear Medicine, Pio XII Foundation, Barretos Cancer Hospital, Barretos, São Paulo, Zip code: 14.784-700, Brazil. marcelojosebr@yahoo.com.br.
authors.forename: Marcelo José
authors.initials: MJ
authors.lastname: Dos Santos
authors.affiliation: Department of Nuclear Medicine, Pio XII Foundation, Barretos Cancer Hospital, Barretos, São Paulo, Zip code: 14.784-700, Brazil.
authors.forename: Euclides Timóteo
authors.initials: ET
authors.lastname: da Rocha
authors.affiliation: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.affiliation: ISTRAD - Institute of Security and Technology on Radiation, Campinas, São Paulo, Brazil.
authors.forename: Eduardo Tinois
authors.initials: ET
authors.lastname: da Silva
authors.affiliation: Department of Pediatrics, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Davi Casale
authors.initials: DC
authors.lastname: Aragon
authors.affiliation: The Heart Institute (Incor), Medical School of São Paulo, University of São Paulo, São Paulo, Brazil.
authors.forename: José Soares
authors.initials: JS
authors.lastname: Junior
mesh_terms: D019797:3-Iodobenzylguanidine; D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D001938:Brazil / Q000453:epidemiology; D066126:Cardiotoxicity / Q000000981:diagnostic imaging / Q000401:mortality; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality*
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
keywords: 123I-mIBG; Cardiac sympathetic activity; anthracycline; left ventricular function