PMID- 16364871
OWN - NLM
STAT- MEDLINE
DCOM- 20060707
LR  - 20131121
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 24
IP  - 12
DP  - 2005 Dec
TI  - Response of doxorubicin-induced cardiomyopathy to the current management strategy 
      of heart failure.
PG  - 2196-201
AB  - BACKGROUND: Doxorubicin (D) (Adriamycin) is a potent and efficacious 
      chemotherapeutic agent in the treatment of various forms of cancer, but its use 
      has been limited by the development of cardiac toxicity. Historically, D-induced 
      cardiomyopathy (CMP) has been refractory to therapy. We report our experience 
      with this form of CMP at the University of Alabama at Birmingham. METHODS: 
      Twenty-five patients (20 women, 5 men) with a clinical diagnosis of D-CMP were 
      referred to our program from 1990 to 2003. Patient data were extracted from 
      office charts. RESULTS: Patients were followed-up for 71 +/- 58 months. On 
      presentation, the average left ventricular ejection fraction (LVEF) was 26 +/- 
      9.2%, and 88% of patients were New York Heart Association (NYHA) Class III or IV. 
      Patients were treated with angiotensin-converting enzyme inhibitors (ACEi; n = 
      23) or angiotensin-receptor blocker (ARB; n = 2), and 15 were treated with a 
      combination of ACEi and beta-blockers (BB). With medical therapy, LVEF improved 
      significantly (26 +/- 9.2% vs 35 +/- 16.5%, p = 0.022), as did the NYHA class (p 
      < 0.003). All survivors (n = 19) were NYHA Class I or II with medical therapy, 
      with 10 (53%) being Class I. In the group of patients treated with ACEi + BB, 
      there was a statistically significant improvement in LVEF (26 +/- 10.0% vs 37 +/- 
      17.6%, p = 0.028), which not seen in the ACEi group, with a strong trend toward 
      normalization of LV function (47% vs 10%, p = 0.054). CONCLUSIONS: In the current 
      era of management of heart failure, D-CMP carries a better prognosis than 
      previously described. Early addition of BB may further improve LVEF.
FAU - Tallaj, Jose A
AU  - Tallaj JA
AD  - Department of Medicine, Birmingham VA Medical Center, Birmingham, Alabama 35294, 
      USA. jtallaj@uab.edu
FAU - Franco, Veronica
AU  - Franco V
FAU - Rayburn, Barry K
AU  - Rayburn BK
FAU - Pinderski, Laura
AU  - Pinderski L
FAU - Benza, Raymond L
AU  - Benza RL
FAU - Pamboukian, Salpy
AU  - Pamboukian S
FAU - Foley, Brian
AU  - Foley B
FAU - Bourge, Robert C
AU  - Bourge RC
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antibiotics, Antineoplastic)
RN  - 80168379AG (Doxorubicin)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Angiotensin Receptor Antagonists
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Antibiotics, Antineoplastic/*adverse effects
MH  - Cardiomyopathies/*chemically induced/*drug therapy
MH  - Doxorubicin/*adverse effects
MH  - Female
MH  - Heart Failure/drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left
EDAT- 2005/12/21 09:00
MHDA- 2006/07/11 09:00
CRDT- 2005/12/21 09:00
PHST- 2004/02/20 00:00 [received]
PHST- 2004/12/01 00:00 [revised]
PHST- 2004/12/14 00:00 [accepted]
PHST- 2005/12/21 09:00 [pubmed]
PHST- 2006/07/11 09:00 [medline]
PHST- 2005/12/21 09:00 [entrez]
AID - S1053-2498(04)01080-0 [pii]
AID - 10.1016/j.healun.2004.12.108 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2005 Dec;24(12):2196-201. doi: 
      10.1016/j.healun.2004.12.108.