title: Noninvasive early detection of anthracycline-induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method.
abstract: Anthracyclines are among the most effective and widely used anticancer drugs; however, their use is limited by serious cardiotoxicity. Early detection is necessary to prevent the high mortality rate associated with heart failure (HF). We evaluated cardiac function in 142 patients using conventional echocardiography and the phased tracking method (PTM), which was measured using the minute vibration and the rapid motion components, neither of which is recognized in standard M-mode nor in tissue Doppler imaging. For systolic function comparison, we compared left ventricular ejection fraction (LVEF) in conventional echocardiography with the average velocity of ventricular septum myocytes (Vave ) in the PTM. The Vave of 12 healthy volunteers was 1.5 (m/s)/m or more. At baseline of 99 patients, there was a positive correlation between LVEF and Vave in all patients. There were no significant differences in baseline cardiac function between patients with and without HF. There was a negative correlation between the cumulative anthracycline dose and LVEF or Vave among all patients. We determined that Vave 1.5 (m/s)/m was equivalent to LVEF 60%, 1.25 (m/s)/m to 55%, and 1.0 (m/s)/m to 50%. During the follow-up period, there was a pathological decrease in LVEF (<55%) and Vave (<1.25 m/s/m) in patients with HF; decreases in Vave were detected significantly earlier than those in LVEF (P < 0.001). When Vave declined to 1.5 (m/s)/m or less, careful continuous observation and cardiac examination was required. When Vave further declined to 1.0 (m/s)/m or lower, chemotherapy was postponed or discontinued; thus, serious drug-induced cardiomyopathy was avoided in patients who did not relapse. The PTM was superior to echocardiography for early, noninvasive detection and intermediate-term monitoring of left ventricle systolic function associated with anthracycline chemotherapy, among patients with hematologic malignancies. The PTM was an effective laboratory procedure to avoid the progression to serious cardiomyopathy.
authors.affiliation: Department of Food and Nutrition, Miyagigakuin Women's University, Sendai, Japan. sy33814@topaz.ocn.ne.jp, ysaitou@mgu.ac.jp.|Sendai Blood Disease Center, Sendai, Japan. sy33814@topaz.ocn.ne.jp, ysaitou@mgu.ac.jp.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Sendai Blood Disease Center, Sendai, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Susukida
authors.affiliation: Sendai Blood Disease Center, Sendai, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Uzuka
authors.affiliation: Graduate School of Biomedical Engineering and the Graduate School of Engineering, Tohoku University, Sendai, Japan. kanai@ecei.tohoku.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology*; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D055088:Early Detection of Cancer / Q000379:methods*; D004452:Echocardiography; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Acute leukemia; anthracycline; cardiotoxicity; echocardiography; malignant lymphoma; phased tracking method