[Effect of propranolol in silent myocardial ischemia induced by anthracyclines]

Effect of propranolol on pain-free myocardial ischemia induced by exposure to anthracyclinic antibiotics were assessed by findings from Holter ECG monitoring in 36 patients with acute lymphoblast leukemia against the background of a complete clinical-and-hematological remission. In those patients having received small cumulative doses of anthracyclines (less than 550 mg/m2) in whom depression of ST-segment had an apparent tachydependent character the severity of pain-free ischemia was shown to be alleviated by a 3-week intake of propranolol. Remarkably, those patients with "silent" myocardial ischemia having received high cumulative doses of cytostatics (more than 550 mg/m2) did not derive much benefit from beta-adrenoblocker, which fact might be associated with the presence in this case of ischemic episodes unrelated to tachycardia.