Document Detail


Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines.
MedLine Citation:
PMID:  22917553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to describe the cardiac magnetic resonance (CMR) findings and determine the prognostic variables in patients with a cardiomyopathy after treatment with anthracyclines. CMR imaging was performed in 91 patients (58% men, mean age 43 ± 18 years, and mean anthracycline dose of 276 ± 82 mg/m(2)) with a reduced ejection fraction after anthracycline-based chemotherapy. Major adverse cardiovascular events were defined as cardiovascular death, appropriate implantable cardioverter-defibrillator therapy, and admission for decompensated heart failure. Patients presented a median of 88 months (interquartile range 37 to 138) after chemotherapy and were followed for 27 months (interquartile range 22 to 38). Late gadolinium enhancement was an uncommon finding (5 patients, 6%) despite a reduced ejection fraction (36 ± 8%). An inverse association was found between the anthracycline dose and the indexed left ventricular (LV) mass by CMR (r = -0.67, p <0.001). A total of 52 adverse cardiac events occurred (event rate of 22%/year). When the patients were grouped according to the presence or absence of a major adverse cardiovascular event, the indexed LV mass and glomerular filtration rate were lower and the anthracycline dose was greater among the patients who experienced an adverse event. In a multivariate model, the indexed LV mass demonstrated the strongest association with major adverse cardiovascular events (hazard ratio 0.89, chi-square 26, p <0.001). In conclusion, myocardial scar by late gadolinium enhancement-CMR is infrequent in patients with anthracycline-cardiomyopathy despite a reduced ejection fraction, the event rate in patients with established anthracycline-cardiotoxicity is high, and indexed LV mass by CMR imaging is a predictor of adverse cardiovascular events.
Authors:
Tomas G Neilan; Otavio R Coelho-Filho; Diego Pena-Herrera; Ravi V Shah; Michael Jerosch-Herold; Sanjeev A Francis; Javid Moslehi; Raymond Y Kwong
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-08-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  110     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-13     Completed Date:  2013-01-15     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1679-86     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anthracyclines / adverse effects*,  therapeutic use
Cardiomyopathies / chemically induced,  diagnosis*,  physiopathology
Female
Heart Ventricles / pathology*
Humans
Magnetic Resonance Imaging, Cine / methods*
Male
Neoplasms / drug therapy*
Prognosis
Stroke Volume / drug effects*
Grant Support
ID/Acronym/Agency:
K08HL097031-02/HL/NHLBI NIH HHS; R01 HL090634/HL/NHLBI NIH HHS; R01 HL091157/HL/NHLBI NIH HHS; R01HL090634-01A1/HL/NHLBI NIH HHS; R01HL091157/HL/NHLBI NIH HHS; T32 HL094301/HL/NHLBI NIH HHS; T32HL09430101A1/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anthracyclines
Comments/Corrections

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