Abstract
This study compared standard m-mode echo (ME) and digitized echocardiography (DE) to detect anthracycline cardiotoxicity. 25 paediatric patients with leukaemias or solid tumors (13 male), mean age - 10.4 yr. (1.9-15.6) had ME before (PRE), at 200-300 mg/m2 (MID), after maximum dosage (POST) of adriamycin or duanorubicin (mean 2.3 months, 0.3-6.5 m) and compared to 33 age matched normals (NORM). 14 had previous chemotherapy some with cyclophosphamide and/or radiation. Mean follow-up duration was 21.5 months (7.8-33.8 m), mean maximum dose was 409.6 mg/m2 (300-582 mg/m2). None had cardiac failure. Left ventricular (LV) systolic time intervals (STI), shortening fraction (SF), mean velocity of shortening (VCF) were done on ME. Peak LV velocity in systole (PLVS) and diastole (PLVD), normalized L.V. velocity in systole (NLVS) and diastole (NLVD), peak posterior wall velocity in systole (NPWVS) and diastole (NPWVD) and similarly peak and normalized septal velocities (PSVS, PSVD, NSVS and NSVD) were obtained by tracing and digitizing the echo (DE). Bonferroni tests of significance were determined. ME showed a) declining VCF from PRE(1.43) to MID(1.23) and POST(1.2) (p=.0005 & .001) b) declining SF from PRE(36.9) to MID(32.7) to POST (32.0) (p=.0002 & .0014) c)STI's were not useful. DE showed a) greater PLVS for PRE(9.47) than NORM(8.21) (p=.0017) but no sig. fall. b)PRE NLVS(2.83) was greater than NORM(2.54) and fell at POST(2.28) (p=.0000 & .0013) c)PLVD & NLVD were normal. Posterior wall and septal motion in systole and diastole was normal except PRE PPWVD(6.85) was greater than NORM(5.17) and fell to normal at MID. Thus 1)ME is as useful for screening for LV dysfunction as DE, 2)DE showed hyperfunction in some parameters PRE. This did not correlate with age, haemoglobin, fever, heart rate, previous therapy or dose. The aetiology of this apparent hyperfunction is not known.
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Sandor, G., Rogers, P., Chan, KW. et al. 136 COMPARISON BETWEEN N MODE AND DIGITIZED ECHOCARDIOGRAPHY IN THE DETECTION OF ANTHRACYCLINE CARDIOTOXICITY. Pediatr Res 19, 133 (1985). https://doi.org/10.1203/00006450-198504000-00166
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DOI: https://doi.org/10.1203/00006450-198504000-00166