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Alterations in left ventricular diastolic function with doxorubicin therapy.

B H Lee, L S Goodenday, G J Muswick

    Journal of the American College of Cardiology
    |January 1, 1987
    PubMed
    Summary

    Impaired diastolic function, specifically reduced rapid and slow filling velocities, may signal early doxorubicin cardiotoxicity before ejection fraction declines. Early assessment of diastolic function is crucial for detecting this chemotherapy side effect.

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    Area of Science:

    • Cardiology
    • Oncology
    • Pharmacology

    Background:

    • Doxorubicin is a widely used chemotherapy agent.
    • Cardiotoxicity is a significant concern with doxorubicin treatment.
    • Early detection of cardiotoxicity is essential for patient management.

    Purpose of the Study:

    • To investigate if impaired diastolic function is an early indicator of doxorubicin-induced cardiotoxicity.
    • To assess changes in left ventricular diastolic function in patients treated with doxorubicin.

    Main Methods:

    • Retrospective study of 12 patients undergoing serial radionuclide angiography.
    • Patients maintained a left ventricular ejection fraction ≥55% before and during doxorubicin treatment.
    • Analysis of diastolic function parameters including filling velocities.

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    Main Results:

    • Significant reductions in average rapid filling velocity (p<0.01) and slow filling velocity (p<0.05) were observed post-doxorubicin.
    • No significant changes noted in filling volume ratio, total diastolic time, or diastolic time ratio.
    • Diastolic function changes occurred independently of significant decreases in ejection fraction.

    Conclusions:

    • Impaired diastolic function may precede declines in left ventricular ejection fraction, serving as an early marker for doxorubicin cardiotoxicity.
    • Evaluating both diastolic and systolic function is recommended for early detection of doxorubicin cardiotoxicity.
    • Prospective studies are needed to confirm these findings and establish clinical implications.