Evaluation of the cardiac effects of doxorubicin by serial echocardiography

Serial echocardiographic studies were performed on 48 children who received chemotherapy with doxorubicin hydrochloride (Adriamycin). For the group as a whole, no correlation could be made between the cumulative dose of doxorubicin administered and left ventricular systolic function as measured by the fractional shortening of the left ventricle (delta s). Two asymptomatic patients, however, demonstrated depressed delta s and abnormal results from radionuclide studies at cumulative doxorubicin doses of less than 430 mg/sq m. Differentiation of the echoderived curve of left ventricular minor axis dimension indicated that these two patients had abnormalities in both diastolic and systolic function. Good correlation was demonstrated between echocardiographic and radionuclide studies in eight patients, including the two with depressed function. Inherent variability limits the sensitivity of echocardiographic functional studies, but serial studies are helpful in the evaluation of cardiac function in children who receive doxorubicin.