title: Preventive role of carvedilol in adriamycin-induced cardiomyopathy.
abstract: OBJECTIVE
  Adriamycin though considered as an effective anticancer drug, leads to irreversible cardiomyopathy (CMP) and congestive heart failure (CHF). The aim of this study was to determine the protective effect of carvedilol in adriamycin (ADR)-induced cardiomyopathy (CMP) in cancer patients.
  
  
  METHODS
  Patients with lymphoreticular malignancy in whom ADR therapy was planned were randomized into two groups: carvedilol and control. Twenty seven patients each were enrolled in carvedilol and control groups. In the carvedilol group, 12.5 mg once daily oral carvedilol was given during six months. The patients were evaluated by echocardiography before and after chemotherapy. Left ventricular ejection fraction (EF) and systolic and diastolic diameters were calculated.
  
  
  RESULTS
  At six months of follow up, six patients in the carvedilol group and five in the control group had died. The mean EF (63.19 vs. 63.88%) and fraction shortening (FS) (34 vs. 34.6) of the carvedilol group were similar at follow up, but in the control group, the mean EF (67.27 vs. 60.82%, P =0.003) and FS (38.48 vs. 34.6, P<0.05) at control echocardiography were significantly lower. In carvedilol group, both systolic and diastolic diameters were not changed, but in control group, systolic diameters were significantly increased compared with basal measures (left ventricular end systolic diameter = 28.26±5.50 mm vs. 31.25± 6.50 mm; P< 0.05).
  
  
  CONCLUSIONS
  Prophylactic use of carvedilol in patients receiving anthracycline protected systolic functions of the left ventricle. Carvedilol can be a potential drug which can ameliorate ADR-induced CMP.
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Jhorawat
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Savita
authors.initials: S
authors.lastname: Kumari
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Subhash C
authors.initials: SC
authors.lastname: Varma
authors.affiliation: Department of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Rohit
authors.affiliation: Department of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Narula
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Suri
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Jain
mesh_terms: D000368:Aged; D002227:Carbazoles / Q000008:administration & dosage*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D000077261:Carvedilol; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000008:administration & dosage*; D013318:Stroke Volume / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
chemical_list: D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D004317:Doxorubicin