© 2007 European Society of Cardiology
Monitoring left ventricular function in adults receiving anthracycline-containing chemotherapy
a Department of Cardiology, Royal Cornwall Hospital Truro, Cornwall, United Kingdom
b Department of Haematology, Royal Cornwall Hospital United Kingdom
c Peninsula Research and Development Support Unit, Royal Cornwall Hospital United Kingdom
* Corresponding author. Tel.: +44 1872 253599 (Business), +44 1872 241689 (Home). E-mail address: markbelham{at}zoom.co.uk
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Abstract |
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Aims: To assess prospectively (1) the incidence of early anthracycline-induced cardiotoxicity; (2) the best predictor for identifying individuals at risk of developing functional cardiotoxicity; and (3) the most sensitive standard echocardiographic measure for the detection of anthracycline-induced changes in left ventricular (LV) function.
Methods: Sixty-seven consecutive patients (45 male, mean age 50±18 years) requiring doxorubicin-containing chemotherapy were enrolled. Clinical and echocardiographic assessments occurred before they received any anthracycline, after low-dose anthracyclines and 1–3 months after completion of their chemotherapy.
Results: Twenty six percent of patients without significant pre-existing cardiac disease developed cardiotoxicity. The parameter that best predicted the development of functional cardiotoxicity was the change in EF between baseline and low dose with an area under the curve of 0.92. The Tei index detected declines in LV function earlier in the course of treatment with anthracyclines and to a greater significance than any other standard echocardiographic measurement but did not predict functional cardiotoxicity.
Conclusions: All patients receiving potential cardiotoxic chemotherapy should be under the care of a cardiologist and have their EF monitored closely.
Key Words: Anthracyclines • Chemotherapy • Cardiotoxicity • Left ventricular function • Tei index • Ejection fraction
Received March 10, 2006; Revised July 31, 2006; Accepted September 14, 2006
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