Abstract
Noninvasive methods to detect early adriamycin-induced cardiac injury and to follow the course of the injury were prospectively studied. Serial physical examinations, chest X rays, electrocardiograms (ECG), and systolic time interval measurements were done. The pre-ejection period to left ventricular ejection time (PEP/LVET) ratio increased in eight of nine patients receiving a cumulative dose of 310 to 540 mg/m2 body surface area of adriamycin. Heart size increased in only two of these patients, and ECG changed in only one. PEP/LVET ratios improved 2 to 6 months after cessation of therapy. Persistently abnormal ratios improved in three of four patients after treatment with digoxin. Patients receiving a cumulative dose of 56 to 290 mg/m2 body surface area of adriamycin showed transient worsening of PEP/LVET ratios that returned to normal by 1 month after therapy. Patients receiving other chemotherapeutic agents had no increase in PEP/LVET ratios. Systolic time interval measurements are valuable in detecting early cardiotoxicity and in reducing the risk of life-threatening heart failure in patients receiving adriamycin.
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