Non-invasive evaluation of anthracycline-induced cardiotoxicity in man.

Abstract

Measurements of radionuclide first-pass left ventricular ejection fraction (LVEFrn) were carried out in 37 patients receiving doxorubicin and/or daunorubicin treatment for their malignant disease. The validity of the systolic time intervals (STI) and echocardiography (ECHO) in the detection of left ventricular dysfunction was evaluated using LVEFrn as reference method. LVEFrn showed a significant decrease in left ventricular function with cumulative anthracycline doses inpatients with and without previous clinical evidence of cardiovascular disease. A multiple regression analysis showed that the impairment in LVEFrn was significantly correlated with the cumulative anthracycline dose, patient's age and previous cardiovascular disease. In five patients (one without previous cardiac disease, one with coronary artery disease, three with hypertension) the drug had to be withdrawn due to signs or symptoms of cardiac dysfunction. The sensitivity and the specificity of STI and ECHO in the detection of left ventricular dysfunction remained rather low as compared with the results by LVEFrn.