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Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
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Published on: January 21, 2018

Doxorubicin cardiomyopathy: evaluation by phonocardiography, endomyocardial biopsy, and cardiac catheterization

M R Bristow, J W Mason, M E Billingham

    Annals of Internal Medicine
    |February 1, 1978
    PubMed

    Insights

    Doxorubicin treatment causes dose-related heart muscle damage, especially in patients over 70 or with prior radiation. Combining multiple assessment methods improves heart failure risk management in these patients.

    Area of Science:

    • Cardiology
    • Oncology
    • Pathology

    Background:

    • Doxorubicin is a widely used chemotherapy agent.
    • Cardiac toxicity is a significant concern with doxorubicin therapy.
    • Early detection and management of doxorubicin-induced cardiotoxicity are crucial.

    Purpose of the Study:

    • To evaluate the relationship between doxorubicin dosage and myocardial damage.
    • To identify risk factors for doxorubicin-associated heart failure.
    • To assess the efficacy of different methods for dose limitation.

    Main Methods:

    • Right ventricular endomyocardial biopsy was performed in 33 adult patients receiving doxorubicin.
    • Right heart catheterization and systolic time intervals were utilized.
    • Histopathological analysis assessed myocyte damage and degenerative changes.

    Main Results:

    • Doxorubicin administration showed a dose-dependent increase in myocyte damage.
    • Significant myocyte damage was observed in 27 of 29 patients at doses ≥ 240 mg/m2.
    • Pre-existing mediastinal radiation and age ≥ 70 years were identified as risk factors for heart failure.

    Conclusions:

    • Doxorubicin causes dose-related myocardial injury, with significant damage at cumulative doses of 240 mg/m2.
    • The pre-ejection period to left ventricular ejection time ratio (PEP/LVET) indicated a threshold effect at 400 mg/m2.
    • Combined clinical, noninvasive, invasive, and morphologic criteria offer superior dose limitation for preventing doxorubicin-induced cardiotoxicity.

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