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Early Diagnosis of Chemotherapy-induced Cardiomyopathy: a Prospective Tissue Doppler Imaging Study

  • Original Paper
  • Published:
Pathology & Oncology Research

Abstract

The aim of our study was to compare the applicability of the conventional echocardiography and a novel method, tissue Doppler imaging (TDI) in detection of late or subclinical cardiotoxicity following anthracycline chemotherapy in long-term follow up. Forty women (31 to 65 years) were enrolled, who had not received anthracyclines previously and had normal cardiac function. The control group consisted of 20 healthy persons of similar age range. In addition to standard echocardiographic measurements, each patient underwent specific measurements (E-septum separation, pulmonary venous flow) as well. Furthermore, the myocardial velocity of numerous segments of the mitral anulus obtained with pulsed wave TDI was also detected over a two-year-long period. Systolic left ventricular function did not change significantly either in the study or in the control group. After one year, diastolic left ventricular function was impaired in 39 patients (97.5%), and 29 (72.5%) of these showed clear changes by means of the traditional E/A ratio and TDI. However, in ten patients (25%) the diastolic dysfunction could only be detected with TDI. At the end of the study diastolic dysfunction was detected in each patient, but in 13 patients (32.5%) the relaxation disorder could be revealed only with TDI. Detectable myocardial damage occurred in the study group as a result of anthracycline therapy. Our results confirmed our assumptions that TDI is a more precise and useful examination method than the traditional ones (E/A ratio or deceleration time) to demonstrate isolated diastolic dysfunction. TDI may become a regularly and more widely used noninvasive method to detect subclinical cardiotoxicity emerging after chemotherapy.

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Abbreviations

AC:

doxorubicin and cyclophosphamide

EC:

epirubicin and cyclophosphamide

ECG:

electrocardiography

EF:

ejection fraction

IVSs and IVSd:

thicknesses of the left ventricular septum in systole and in diastole

LVPWs and LVPWd:

thicknesses of the left ventricular posterior wall in systole and in diastole

LVEDs and LVEDd:

left ventricular end-diastolic dimension in systole and in diastole

TDI:

tissue Doppler imaging

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Authors and Affiliations

  1. 1st Department of Internal Medicine and Cardiology, Uzsoki Municipal Hospital, Uzsoki u. 29, Budapest, H-1145, Hungary

    András Csaba Nagy

  2. Semmelweis University, Budapest, Hungary

    Zsuzsanna Cserép

  3. 2nd Department, Pest County Institute of Pulmonology, Törökbálint, Hungary

    Edina Tolnay

  4. Oncoradiological Centre, Uzsoki Municipal Hospital, Budapest, Hungary

    Tamás Nagykálnai

  5. 2nd Department of Internal Medicine and Cardiological Centre, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary

    Tamás Forster

Authors
  1. András Csaba Nagy
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  2. Zsuzsanna Cserép
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  3. Edina Tolnay
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  4. Tamás Nagykálnai
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  5. Tamás Forster
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Correspondence to András Csaba Nagy.

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Nagy, A.C., Cserép, Z., Tolnay, E. et al. Early Diagnosis of Chemotherapy-induced Cardiomyopathy: a Prospective Tissue Doppler Imaging Study. Pathol. Oncol. Res. 14, 69–77 (2008). https://doi.org/10.1007/s12253-008-9013-4

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  • DOI: https://doi.org/10.1007/s12253-008-9013-4

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