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Updated: Apr 25, 2026

Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
Moderate-dose doxorubicin does not affect right ventricular size or function parameters in lymphoma patients-a
Eduardo Brenner-Muslera1, Maria F Gomez-Ardila1, Eduardo Tellez-Garcia1
1Division of Cardiovascular Ultrasound, Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Aims:
We sought to determine whether doxorubicin affected echocardiographic parameters of right ventricular (RV) size and function when compared with guideline defined values in patients with lymphoma.
Methods And Results:
We enrolled 356 patients with lymphoma from 2013 to 2020. Patients received a mean (SD) of 5.12 (1.48) chemotherapy cycles and a cumulative, body surface area-adjusted doxorubicin dosage of 243.6 (79.6) mg/m2. Echocardiographic assessments occurred at 3 time points: T0, baseline; T1, 3 to 6 months after starting doxorubicin (mean [SD], 5.1 [1.2] months); and T2, 6 to 18 months (mean [SD], 12.98 [2.6] months) after treatment. End-diastolic area remained unchanged (P = 0.12). End-systolic area increased from 10.55 cm2 at T0 to 11.41 cm2 at T1 and 11.32 cm2 at T2 (P < 0.001). Fractional area change decreased from 46.67% at T0 to 44.35% at T1 and 44.40% at T2 (P = 0.003). Tricuspid annular plane systolic excursion decreased from 23.17 (4.14) mm to 22.39 (4.10) mm at T1, and 22.13 (3.88) mm at T2 (P = 0.006). S' declined from 0.14 m/s at T0 to 0.13 m/s at T1 and T2 (P < 0.001). Tricuspid regurgitant velocity (P = 0.58) and RV systolic pressure (P = 0.75) showed nonsignificant changes. RV free wall strain worsened from -26.29% at T0 to -25.37% at T2 (P = 0.001). All parameters remained within guideline defined values (P < 0.001). No significant differences were noted across dosage groups: <200, 200-300, and >300 mg/m2.
Conclusion:
Echocardiography derived parameters of right ventricular size and function remained within normal guideline-defined values throughout a follow-up of up to 12.98 ± 2.6 months.
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