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Echocardiographic findings in children treated for malignancy with chemotherapy including adriamycin
L Solymar1, I Marky, L Mellander
1Department of Paediatrics I, Gothenburg University, Sweden.
Insights
Adriamycin chemotherapy in children can impair left ventricular function, with 30% showing abnormalities and 45% developing dilated ventricles. Three patients experienced heart failure, highlighting the cardiotoxic potential of this treatment.
Area of Science:
- Pediatric Oncology
- Cardiology
- Cardiotoxicity
Background:
- Adriamycin (doxorubicin) is a vital chemotherapeutic agent.
- Chemotherapy, including adriamycin, can pose risks to cardiac function in pediatric patients.
- Echocardiography is a key tool for assessing cardiac health.
Purpose of the Study:
- To evaluate the cardiac effects of adriamycin-based chemotherapy in children.
- To identify echocardiographic indicators of cardiotoxicity in this population.
- To assess the incidence of left ventricular dysfunction and dilation.
Main Methods:
- Echocardiography was performed on 37 children undergoing chemotherapy with adriamycin.
- Systolic time intervals (STI) and left ventricular shortening fraction (delta LVID) were assessed.
- Cardiac structure and function were analyzed.
Main Results:
- Abnormal left ventricular function (STI and/or delta LVID) was observed in 30% of patients.
- 45% of patients exhibited left ventricular dilation, often with thinned walls.
- Three patients developed congestive heart failure, one with a fatal outcome, linked to adriamycin and chest irradiation.
Conclusions:
- Adriamycin chemotherapy is associated with significant left ventricular dysfunction and dilation in children.
- Echocardiographic parameters, particularly delta LVID, are crucial for detecting cardiotoxicity.
- Close cardiac monitoring is essential for pediatric patients receiving adriamycin, especially with concurrent chest irradiation.
Abstract:
Thirty-seven children receiving chemotherapy including adriamycin were studied with echocardiography. Abnormal left ventricular function assessed by systolic time intervals (STI) and/or left ventricular shortening fraction (delta LVID) was present in 30%, and dilated left ventricle was in 45% of the case, often accompanied by thinning the left ventricular wall. Three patients developed congestive heart failure, one with fatal outcome. Two of these patients had received chest irradiation along with the chemotherapeutic treatment. These three patients with overt heart failure had gross abnormalities in several echocardiographic variables of which delta LVID seemed most specific.