Eighteen patients were examined by Doppler echocardiography before and after treatment with doxorubicin (DXR). Early left ventricular filling rate decreased from 66±15 to 51±10 cm/sec whereas late filling rate increased from 48±12 to 61±9 cm/sec (p < 0.05) with inversion of the E/A ratio suggesting an impairment of left ventricular diastolic function; conversely no significant changes were found in systolic function indexes. These results suggest that follow-up of patients treated with DXR must include left ventricular diastolic function studies. Doppler echocardiography can be successfully used to detect the presence of diastolic abnormalities.
Get full access to this article
View all access options for this article.
References
1.
AlexanderJ., DainiakN., BergerH.J., GoldmanL., JohnstoneD., RedutoL., DufyT., SchwartzP., GottschalkR., ZaretB.L.: Serial assessment of doxorubicin cardiotoxicity with quantitative radionuclide angiocardiography.N. Engl. J. Med., 300: 278–383, 1979.
2.
BalcerzakS.P., ChristakisJ., LewisR.P., OlsonH.M., MalspeisL.: Systolic time intervals in monitoring adriamycin-induced cardiotoxicity.Cancer Treat. Rep., 62: 893–899, 1978.
FigerM.A., BorowK.M., ColanS., LorellB.: Left ventricular diastolic filling rate: contributions of the heart rate, age and extent of systolic shortening (abstr).Circulation, 68 (suppl. III): 101, 1983.
9.
GottdienerJ.S., MathisenD.J., BorerJ.S., BonowR.O., MeyersC.E., BarrL.H., SchwartzD.E., BacharachS.L., GreenM.V., RosenbergS.A.: Doxorubicin cardiotoxicity: assessment of late left ventricular dysfunction by radionuclide cineangiography.Ann. Intern. Med., 94: 430–445, 1981.
10.
HendersonI.C., SlossL.J., LaffeN., BlumE., FreiE.: Serial studies of cardiac function in patients receiving adriamycin.Cancer Treat. Rep., 62: 923–929, 1978.
11.
LeeB.H., GoodendayL.S., MuswickG.J., YasnoffW.A., LeightonR.F., SkeelR.T.: Alterations in left ventricular diastolic function with doxorubicin therapy.JACC, 9: 184–188, 1987.
12.
LefrakE.A., PithaJ., RosenheinS., GottliebJ.A.: A clinicopathologic analysis of adriamycin cardiotoxicity.Cancer, 39: 1397–1402, 1973.
13.
MinowR.A., BenjaminR.S., GottliebJ.A.: Adriamycin (NSC-123127) cardiomyopathy: an overview with determination of risk factors.Cancer Chemother. Rep., 6 (part 3): 195–201, 1975.
RokeyP., KuoL.C., ZoghbiW.A., LimacherM.C., QuinonesM.A.: Determination of parameters of left ventricular diastolic filling with pulsed-Doppler echocardiography: comparison with cineangiography.Circulation, 71: 573, 1985.
18.
SingerJ.W., NaraharaK.A., RitchieJ.L., HamiltonG.W., KennedyJ.W.: Time and dose dependent changes in ejection fraction determined by radionuclide angiography after anthracycline therapy.Cancer Treat. Rep., 62: 945–948, 1978.
19.
SpiritoP., MaronB.J., BonowR.: Non invasive assessment of left ventricular diastolic function: comparative analysis of Doppler echocardiographic and radionuclide angiographic techniques.JACC, 7(3): 518–526, 1986.
20.
Von HoffD.D., LayardM.W., BasaP., DavisH.L., Von HoffA.L., RozencweigM., MuggiaM.F.: Risk factors for doxorubicin-induced congestive heart failure.Ann. Intern. Med., 91: 710–717, 1979.
