PMID- 18091640
OWN - NLM
STAT- MEDLINE
DCOM- 20080307
LR  - 20161124
IS  - 0026-4725 (Print)
IS  - 0026-4725 (Linking)
VI  - 55
IP  - 6
DP  - 2007 Dec
TI  - Assessment of left ventricular systolic dysfunction by tissue Doppler imaging to 
      detect subclinical cardiomyopathy early after anthracycline therapy.
PG  - 711-20
AB  - AIM: Anthracycline (ANT) chemotherapy for breast cancer, while associated with 
      high response rates, is fraught by risks of irreversible cardiotoxicity. 
      Unfortunately means to detect such cardiotoxicity early on and at a sublinical 
      stage are lacking. We evaluated the role of systolic tissue Doppler imaging (TDI) 
      in appraising postchemotherapy left ventricular (LV) remodelling. METHODS: 
      Patients undergoing ANT-chemotherapy for breast cancer were enrolled, and 
      underwent baseline and >6-months echocardiography (standard and TDI). According 
      to the pattern of LV-TDI systolic remodelling from baseline to follow-up, 
      patients were stratified in: group 1 (no LV-TDI worsening), group 2 (minor LV-TDI 
      worsening), and group 3 (major LV-TDI worsening). Fifty-six patients were 
      included (follow-up 9+/-6 months). RESULTS: At baseline, no patient had abnormal 
      LV ejection fraction (LVEF), LV-TDI systolic dysfunction or New York Heart 
      Association (NYHA) >1. Follow-up overall analysis showed significant 
      deterioration in LVEF, end-diastolic diameter (EDD) end-systolic diameter (ESD), 
      and TDI-systolic parameters (all P<0.05). Specifically, 29 (51.8%) patients 
      showed no adverse LV-TDI systolic remodelling, while 17 (30.4%) were in group 2, 
      and 10 (17.9%) in group 3. All groups shared similar conditions at baseline. 
      Patients with adverse LV-TDI remodelling had significant increases in EDD and 
      ESD, as well as a significantly decreased LVEF (all P<0.05). No patient in group 
      1 had abnormal LVEF at follow-up, while 1 patient in group 2 and 2 patients in 
      group 3 had abnormal LVEF (P<0.05). CONCLUSION: Subclinical systolic dysfunction 
      occurs in almost 50% of patients early after chemotherapy for breast cancer, with 
      a more adverse by LV-TDI remodelling implying a more pronounced deterioration of 
      standard echocardiographic parameters.
FAU - Lotrionte, M
AU  - Lotrionte M
AD  - Division of Heart Failure and Cardiac Rehabilitation, Cardiovascular Department, 
      Catholic University of the Sacred Heart Rome, Italy.
FAU - Palazzoni, G
AU  - Palazzoni G
FAU - Natali, R
AU  - Natali R
FAU - Comerci, G
AU  - Comerci G
FAU - Abbate, A
AU  - Abbate A
FAU - Loperfido, F
AU  - Loperfido F
FAU - Biondi-Zoccai, G
AU  - Biondi-Zoccai G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
RN  - 0 (Anthracyclines)
SB  - IM
MH  - Adult
MH  - Anthracyclines/*adverse effects
MH  - Breast Neoplasms/*drug therapy
MH  - Cardiomyopathies/*chemically induced/diagnosis/diagnostic imaging
MH  - Data Interpretation, Statistical
MH  - Diastole
MH  - *Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Systole
MH  - Time Factors
MH  - Ventricular Dysfunction, Left/*diagnosis
EDAT- 2007/12/20 09:00
MHDA- 2008/03/08 09:00
CRDT- 2007/12/20 09:00
PHST- 2007/12/20 09:00 [pubmed]
PHST- 2008/03/08 09:00 [medline]
PHST- 2007/12/20 09:00 [entrez]
PST - ppublish
SO  - Minerva Cardioangiol. 2007 Dec;55(6):711-20.