title: Effect of Enalapril on Preventing Anthracycline-Induced Cardiomyopathy.
abstract: Anthracycline (ANT) is a topoisomerase-interacting agent that is used in most malignancy treatments. We investigated the efficacy of enalapril (angiotensin-converting enzyme inhibitor) in the prevention of ANT-induced cardiomyopathy. In this randomized, single-blind, and placebo-controlled study, 69 patients with a newly diagnosed malignancy for which ANT therapy was planned were randomly assigned to either a group receiving enalapril (n = 34) or placebo (n = 35). Echocardiography studies were performed before chemotherapy and at 6 months after randomization. Additionally, troponin I and creatinine kinase-MB (CK-MB) were measured 1 month after the initiation of chemotherapy. In the enalapril group, the mean left ventricular ejection fraction (LVEF) (p = 0.58) was the same at baseline and 6 months after randomization. Conversely, LVEF significantly decreased in the control group (p < 0.001). Additionally, LV end systolic volume and left atrial diameter were significantly increased compared with the baseline measures in the control group. According to the tissue Doppler study, the mitral annuli early diastolic (e') and peak systolic (s') velocities were significantly reduced, and the E (the peak early diastolic velocity)/e' ratio was significantly increased in the control group. Furthermore, the TnI and CK-MB levels were significantly higher in the control group than in the enalapril group. Enalapril appears efficacious in preserving systolic and diastolic function in cancer patients treated with ANTs.
authors.affiliation: Department of Hematology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Ghasem
authors.initials: G
authors.lastname: Janbabai
authors.affiliation: Department of Cardiology, Faculty of Medicine, Fatemeh Zahra Teaching Hospital, Mazandaran University of Medical Sciences, Artesh Boulevard, Sari, 48188-13771, Iran. Dr.mr.nabati@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Nabati
authors.affiliation: Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Faghihinia
authors.affiliation: Department of Pathology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Azizi
authors.affiliation: Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Borhani
authors.affiliation: Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Yazdani
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control*; D066126:Cardiotoxicity; D052279:Creatine Kinase, MB Form / Q000097:blood; D019610:Cytoprotection; D015150:Echocardiography, Doppler; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D016037:Single-Blind Method; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D059003:Topoisomerase Inhibitors / Q000009:adverse effects*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control*; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D015415:Biomarkers; D059003:Topoisomerase Inhibitors; D019210:Troponin I; D004656:Enalapril; D052279:Creatine Kinase, MB Form
keywords: Anthracyclines; Anticancer drug; Cardio protection; Cardiotoxicity