Early detection of anthracycline-induced cardiotoxicity

Abstract

Introduction: Cancer is the most dreaded disease known to mankind. Cardiotoxicity is a complication of antineoplastic treatment, which can be detected early by echocardiogram.

Objective: To identify echocardiographic variables related to the occurrence of cardiotoxicity by anthracycline.

Method: A descriptive, prospective and longitudinal study was conducted with all patients admitted to the Hematology Department of Hermanos Ameijeiras Surgical Clinical Hospital, from January 2010 to January 2012. 28 patients who received chemotherapy with anthracyclines were studied. The general information of each patient, as well as the information concerning the transthoracic echocardiogram, was obtained during hospitalization, at one, 6 and 12 months.

Results: 69.3% of patients who developed cardiotoxicity were older than 45 years and there was a predominance of males (76.9%). 56.8% had cardiotoxicity at a dose lower than 550 mg/m2 (p = 0.032). Strain rate/Ɛ values in patients who developed cardiotoxicity were significantly reduced at one month [0.8638/0.2 (p = 0.043) and 13.77/ 4.1 (p = 0.031)]; while LVEF remained normal [54.6 ± 4 (p = 0.036)]. Regarding volume/pressure of the left atrium, there was an increase in the reference values (21.13 ± 5.08 ml and 10.91 ± 0.57 mmHg), although without statistical significance (p = 0.217 and p = 0.728).

Conclusions: Strain rate/Ɛ technique has been helpful for early diagnosis of cardiotoxicity.