Right ventricle wall motion abnormalities in patients treated with chemotherapy

Doxorubicin is a cytotoxic agent used in the treatment of patients with various malignancies. Its clinical value is limited by a dose-related cardiotoxicity. Wall motion was analyzed in 52 patients during different stages of treatment. Eleven patients were studied once, and in 41 patients serial radionuclide ventriculography was performed from 2 to 5 times. Abnormal wall motion was found in 96 out of 1,062 segments (9.0%), of which 33 out of 735 (4.5%) were in the left ventricle (LV) and 65 out of 327 (19.9%) were in the right ventricle (RV). The number of abnormalities in the RV was significantly higher than in the LV (P less than 0.001). Regional analysis of LV and RV in 109 40 degrees LAO studies and in 102 75 degrees LAO studies showed abnormal wall motion in the following segments: LV--posterobasal 6 (5.9%), inferior 2 (2.0%), anterior 5 (4.9%), anteroseptal 11 (10.1%), apical 5 (4.6%), posterolateral 4 (3.7%); RV--septal 44 (40.4%), apex 15 (13.8%), and the free wall 6 (5.5%). The left ventricular ejection fraction decreased from 74% median (M) in baseline studies to 54% (M) in the highest dose group (greater than 650 mg/m2). The present data show an increased number of wall motion abnormalities in the RV compared with the LV, particularly in the RV septum (P less than 0.001).