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Anthracycline cardiotoxicity: Clinical and pathologic outcomes assessed by radionuclide ejection fraction
Author(s) -
Ritchie James L.,
Singer Jack W.,
Thorning David,
Sorensen Sherman G.,
Hamilton Glen W.
Publication year - 1980
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19800901)46:5<1109::aid-cncr2820460506>3.0.co;2-b
Subject(s) - medicine , ejection fraction , cardiotoxicity , anthracycline , heart failure , cardiomyopathy , depression (economics) , radionuclide angiography , cardiology , toxicity , cancer , breast cancer , economics , macroeconomics
A clinical syndrome of severe cardiomyopathy often accompanies administration of high doses of anthracycline agents. We studied 36 patients serially with radionuclide angiography. At three weeks following drug administration, 8 of 36 patients showed depression of ejection fraction (EF). All had received at least 280 mg/M 2 of the drug and 7 had received more than 380 mg/M 2 . Definite clinical syndromes of congestive cardiomyopathy developed only in patients showing EF depression and in some patients, EF depression developed without signs of congestive heart failure. Ejection fraction studies at 5 minutes, 1 hour, 4 hours, 24 hours, 72 hours, and one week following drug administration showed no changes when compared to immediate pre‐drug EF. Seven patients who died during the study underwent histologic examination. Only the single patient with a depressed EF showed histologic evidence of anthracycline cardiotoxicity, although all but 1 of these patients had received at least 400 mg/M 2 . We conclude that serial radionuclide EF just prior to anthracycline administration is a potentially useful predictor of cardiac toxicity, and that EF depression and/or preservation of a normal EF should be weighed in the decision for administering a drug of this type at high dosage levels.