Russian Heart Failure Journal 2005year Structural and functional parameters of the left ventricle in doxorubicin chemotherapy and idiopathic dilated myocardiopathy
Structural and functional parameters of the left ventricle in doxorubicin chemotherapy and idiopathic dilated myocardiopathy
Katamadze N.A., Lartsuliany K.P., Kiknadze , Begishvili N.N.
Aim of study was to investigate LV structural and functional parameters in doxorubicin chemotherapy and idiopathic dilated myocardiopathy as well as to study dynamics of LV systolo-diastolic dysfunction in relation to the increasing doxorubicin dosage. Ninety nine patients were examined including 49 patients with malignant blood diseases (23 with non-Hodgkin’s lymphoma; 21 with Hodgkin’s lymphoma; 5 with chronic lymphatic leukemia) and 50 patients with idiopathic dilated myocardiopathy. Patients were divided into three subgroups in relation to the total dose of taken doxorubicin: I subgroup, 232.2±5.8 mg/m² II subgroup, 388±15.3 mg/m² III subgroup, 533.1±13.6 mg/m². The LV systolo-diastolic function was evaluated twice using echoCG. Consistent dose-dependent evolution of doxorubicin cardiotoxicity was observed, which eventually resulted in development of anthracycline myocardiopathy. In anthracycline myocardiopathy, LV undergoes the same structural and functional alterations as in idiopathic dilated myocardiopathy: LV eccentric hypertrophy (II type LV remodeling with myocardial mass index >120 g/m² and relative thickness of LV posterior wall <0.44); decreased LV EF; increased LV systolo-diastolic dimensions/volumes; LV diastolic dysfunction of the restrictive type. Doxorubicin cardiotoxicity is evident as early as at low total doses (232 mg/m²); at a «critical dose» (356-388 mg/m²) LV diastolic dysfunction with clinical signs of HF develops; at a total dose of 533 mg/m² anthracycline dilated myocardiopathy with LV systolo-diastolic dysfunction and clinical signs of HF develops in 100% of cases.