Document Detail


Diagnosis of anthracycline-induced late cardiomyopathy by exercise-spiroergometry and stress-echocardiography.
MedLine Citation:
PMID:  11686505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anthracyclines are used in the therapy of several of the most common paediatric oncological disorders. The usefulness of these agents is limited by cardiotoxicity, with congestive heart failure developing in up to 20% of patients. To stratify possible risk factors, we investigated 38 children with acute lymphoblastic leukaemia for signs of late cardiomyopathy. Exercise-spiroergometry and stress-echocardiography with measurement of fractional shortening (FS) and ejection fraction (EF) as indicators of left ventricular function were performed. ECG, 24 h Holter monitoring, chest X-ray, virus serology and carnitine were analysed. Control subjects were 38 healthy children matched for age and body surface area. All 38 patients had normal echocardiographic findings at rest (EF: 0.73 +/- 0.06; FS: 0.35 +/- 0.05). ten patients had a significant attenuation of left ventricular function after exercise assessed by stress-echocardiography compared to the remaining 28 patients and 38 healthy control subjects (EF: 0.52 +/- 0.08 versus 0.77 +/- 0.06 and 0.80 +/- 0.08; FS: 0.29 +/- 0.06 versus 0.39 +/- 0.05 and 0.41 +/- 0.02); patients with reduced ventricular function after exercise had significant low anaerobic threshold, subnormal maximal oxygen uptake and decreased carnitine levels. The findings were not related to the dosage of administered doxorubicin. There exists no correlation between ECG, 24 h ECG, chest X-ray, virology and left ventricular dysfunction. The benefit of angiotensin converting enzyme inhibitors and the administration of carnitine remains speculative. Conclusion: exercise-spiroergometry and stress-echocardiography are sensitive investigations for diagnosing subclinical cardiomyopathy late after completion of chemotherapy. Investigative findings of cardiomyopathy are not dose related and may provide information for therapeutic prevention before clinical symptoms of cardiomyopathy appear.
Authors:
M Hauser; B S Gibson; N Wilson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of pediatrics     Volume:  160     ISSN:  0340-6199     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-31     Completed Date:  2002-02-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  607-10     Citation Subset:  IM    
Affiliation:
Deutsches Herzzentrum, Department of Paediatric Cardiology, Munich, Germany. hauser@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Antibiotics, Antineoplastic / adverse effects*
Cardiomyopathies / chemically induced*,  diagnosis,  physiopathology
Child
Child, Preschool
Cohort Studies
Echocardiography / methods
Electrocardiography
Exercise Test / methods
Female
Humans
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
Spirometry / methods
Stroke Volume / drug effects
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Antibiotics, Antineoplastic

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