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Monitoring of cardiac function by serum cardiac troponin T levels, ventricular repolarisation indices, and echocardiography after conditioning with fractionated total body irradiation and high‐dose cyclophosphamide
Author(s) -
Auner H.W.,
Tinchon C.,
Brezinschek R.I.,
Eibl M.,
Sormann S.,
Maizen C.,
Linkesch W.,
SchmonKampel R.,
Quehenberger F.,
Tiran A.,
Sill H.
Publication year - 2002
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1034/j.1600-0609.2002.01661.x
Subject(s) - medicine , cardiology , cyclophosphamide , total body irradiation , cardiotoxicity , troponin complex , cardiac function curve , electrocardiography , heart failure , troponin , chemotherapy , anesthesia , myocardial infarction
Objectives: Highly differing rates of cardiac complications associated with high‐dose cyclophosphamide (CY) have been reported, and only one clinical study has been performed on the cardiotoxic effects of CY monotherapy following total body irradiation (TBI).Patients and methods: We prospectively evaluated the potential cardiotoxic effects of conditioning with fractionated total body irradiation and high‐dose cyclophosphamide (TBI/CY) by serial measurement of serum cardiac troponin T (cTnT), assessment of systolic and diastolic echocardiographic parameters and analysis of ventricular repolarisation indices (QT‐dispersion and corrected QT‐dispersion) in 30 adult patients with haematological malignancies undergoing haematopoietic stem cell transplantation.Results:There was no evidence of pretreatment cardiac dysfunction in any patient. Although cTnT was determined serially for a median of 14 d after completion of conditioning, no elevated levels were observed. Echocardiographic parameters did not show any significant change at a median follow‐up of 5 months except for one patient with evidence of impaired diastolic filling. No significant differences for mean values before and after high‐dose CY were noted for ventricular repolarisation indices. Two patients had a significant increase in corrected QT‐dispersion after CY without any other signs of cardiotoxicity. Congestive heart failure or arrythmias were not observed.Conclusions : These data suggest that TBI/CY is safe with respect to cardiotoxicity in patients without pre‐existing cardiac dysfunction. Hitherto unknown synergistic cardiotoxic effects of CY with other cytostatic drugs may constitute the major pathogenic factor of myocardial dysfunction after high‐dose chemotherapy.