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Longitudinal evaluation of anthracycline cardiotoxicity by signal‐averaged electrocardiography in children with cancer
Author(s) -
FukuMi Daichi,
Uchikoba Yohko,
Maeda Miho,
Ogawa Shunichi
Publication year - 2002
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1328-8067.2001.01526.x
Subject(s) - cardiotoxicity , medicine , anthracycline , electrocardiography , cumulative dose , subclinical infection , cardiology , heart failure , heart rate , chemotherapy , anesthesia , cancer , breast cancer , blood pressure
Background: The aim of the present study was to investigate the detection of anthracycline cardiotoxicity by signal‐averaged electrocardiography (SAE) in children with cancer.Methods: There were 29 patients with a cumulativeanthracycline (ATC) dose of 75−600 mg/m 2 .None of them had congestive heart failure. Patients underwent SAEjust before (detection of chronic cardiotoxicity) and just after(detection of acute cardiotoxicity) ATC therapy. Echocardiographyand Holter electrocardiography were performedat the same time. The rates of abnormal SAE, echocardiography, andelectrocardiogram findings were calculated and compared for every100 mg/m 2 of ATC.Results: The SAE showed a significantly higherdetection rate for acute cardiotoxicity was at a cumulative ATCdose of less than 400 mg/m 2 when comparedwith other methods ( P < 0.05).The lowest dose at which acute cardiotoxicy was detected by SAEwas 117.3 mg/m 2 . The detection of chroniccardiotoxicity by SAE was significantly higher at a cumulative ATCdose of 100−400 mg/m 2 whencompared with other methods ( P < 0.05),and the lowest value showing toxicity was 373.3 mg/m 2 .The lowest ATC dose causing chronic cardiotoxicity was significantlylower in patients less than 2‐years‐old (120.0 ± 28.3 mg/m 2 )than in the other age groups ( P < 0.05).Conclusions: Acute and chronic ATC cardiotoxicity were detected by SAE at lower cumulative doses compared with other methods. The technique of SAE was a potentially useful method for detection of cardiotoxicity among those investigated and it provides useful information on subclinical cardiac dysfunction in patients receiving ATC therapy.