Marcelo José Dos Santos1, Euclides Timóteo da Rocha2, Hein J Verberne3, Eduardo Tinois da Silva4, Davi Casale Aragon5, José Soares Junior6. 1. Department of Nuclear Medicine, Pio XII Foundation, Barretos Cancer Hospital, Barretos, São Paulo, Zip code: 14.784-700, Brazil. marcelojosebr@yahoo.com.br. 2. Department of Nuclear Medicine, Pio XII Foundation, Barretos Cancer Hospital, Barretos, São Paulo, Zip code: 14.784-700, Brazil. 3. Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 4. ISTRAD - Institute of Security and Technology on Radiation, Campinas, São Paulo, Brazil. 5. Department of Pediatrics, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. 6. The Heart Institute (Incor), Medical School of São Paulo, University of São Paulo, São Paulo, Brazil.
Abstract
PURPOSE: The goal of this study was to evaluate late cardiotoxic effects of anthracyclines (ATC) by evaluating cardiac sympathetic activity in a cohort of asymptomatic patients previously treated with ATC for childhood cancers. METHODS: We studied 89 asymptomatic patients previously treated with ATC with a normal echocardiogram (49 men and 40 women) and a control group of 40 healthy individuals (26 men and 14 women). Both groups underwent planar myocardial 123I-meta-iodobenzylguanidine scintigraphy (123I-mIBG). From these images, the early and late heart-to-mediastinum (H/M) ratio and washout rate (WR) were assessed. RESULTS: The mean survival at the time of the 123I-mIBG scintigraphy was 5.3 ± 3.4 years. Patients treated with ATC had a lower but clinical normal left ventricular ejection fraction (LVEF) compared to controls (60.44 ± 6.5 vs 64.1 ± 6.0%, P < 0.01). Both the late H/M ratio and WR were not able to discriminate ATC treated patients from controls. The cumulative ATC dose was the only independent predictor of the LVEF, explaining approximately 12% of the variation in LVEF (P = 0.01). CONCLUSIONS: Although the pathophysiology behind ATC cardiotoxicity is most likely multifactorial, myocardial sympathetic activity is not associated with a reduction in LVEF 5-years after completion of chemotherapy.
PURPOSE: The goal of this study was to evaluate late cardiotoxic effects of anthracyclines (ATC) by evaluating cardiac sympathetic activity in a cohort of asymptomatic patients previously treated with ATC for childhood cancers. METHODS: We studied 89 asymptomatic patients previously treated with ATC with a normal echocardiogram (49 men and 40 women) and a control group of 40 healthy individuals (26 men and 14 women). Both groups underwent planar myocardial 123I-meta-iodobenzylguanidine scintigraphy (123I-mIBG). From these images, the early and late heart-to-mediastinum (H/M) ratio and washout rate (WR) were assessed. RESULTS: The mean survival at the time of the 123I-mIBG scintigraphy was 5.3 ± 3.4 years. Patients treated with ATC had a lower but clinical normal left ventricular ejection fraction (LVEF) compared to controls (60.44 ± 6.5 vs 64.1 ± 6.0%, P < 0.01). Both the late H/M ratio and WR were not able to discriminate ATC treated patients from controls. The cumulative ATC dose was the only independent predictor of the LVEF, explaining approximately 12% of the variation in LVEF (P = 0.01). CONCLUSIONS: Although the pathophysiology behind ATCcardiotoxicity is most likely multifactorial, myocardial sympathetic activity is not associated with a reduction in LVEF 5-years after completion of chemotherapy.
Entities:
Keywords:
123I-mIBG; Cardiac sympathetic activity; anthracycline; left ventricular function
Authors: James R Corbett; Olakunle O Akinboboye; Stephen L Bacharach; Jeffrey S Borer; Elias H Botvinick; E Gordon DePuey; Edward P Ficaro; Christopher L Hansen; Milena J Henzlova; Serge Van Kriekinge Journal: J Nucl Cardiol Date: 2006-11 Impact factor: 5.952
Authors: Bonnie Ky; Benjamin French; Kosha Ruparel; Nancy K Sweitzer; James C Fang; Wayne C Levy; Douglas B Sawyer; Thomas P Cappola Journal: J Am Coll Cardiol Date: 2011-07-19 Impact factor: 24.094
Authors: Henk Visscher; Colin J D Ross; S Rod Rassekh; Amina Barhdadi; Marie-Pierre Dubé; Hesham Al-Saloos; George S Sandor; Huib N Caron; Elvira C van Dalen; Leontien C Kremer; Helena J van der Pal; Andrew M K Brown; Paul C Rogers; Michael S Phillips; Michael J Rieder; Bruce C Carleton; Michael R Hayden Journal: J Clin Oncol Date: 2011-09-06 Impact factor: 44.544
Authors: Maxime Caru; Denis Corbin; Delphine Périé; Valérie Lemay; Jacques Delfrate; Simon Drouin; Laurence Bertout; Maja Krajinovic; Caroline Laverdière; Gregor Andelfinger; Daniel Sinnett; Daniel Curnier Journal: Clin Res Cardiol Date: 2019-02-18 Impact factor: 5.460