Adriamycin cardiotoxicity. Prognostic value of the systolic time intervals

The aim of this study was to detect the cardiotoxicity of Adriamycin (ADM) by the evolution of the systolic time intervals (STI). The PEP/LVET ratio represents an easy and reproducible index of myocardial function. The more important this increase, the greater the risk of developing heart failure. A significant correlation exists between the variation of this ratio and the total administered dose, but the correlation coefficient is low. A heart failure may appear for doses of ADM under 500 mg/m2 but it is preceded by an increase of the index. In the absence of a significant modification, the generally admitted maximum dose of 550 mg/m2 may be exceeded. In case of a ratio increase in excess of 0.08 it will be necessary to balance the potential benefits of treatment with the hazards of cardiac failure. The PEP/LVET ratio allows proceeding with the cytostatic treatment in increased security by selecting the patients at high risk for cardiac failure.