R-wave voltage in the right precordial leads in anthracycline cardiomyopathy: a clinical study.

It was observed that the QS pattern in the right precordial leads of electrocardiograms of patients treated with anthracycline antibiotics resulted in congestive heart failure. In a review of the literature dealing with patients with anthracycline cardiomyopathy, terminal electrocardiograms, when available, showed the QS pattern in the right precordial leads in all patients. The relationship between a decreased R-wave voltage in lead V1 and an increase of the anthracycline dose was evaluated by a clinical study of ten patients. Analysis was subdivided into two categories (group A and B). In group A, there was a dose-response relationship. Electrocardiograms in group B, on the other hand, did not show low R-waves. The present study suggests that increased injury to myocardial cells in the regions of the anterior septum and anterior left ventricular wall might be important in the pathogenesis of anthracycline cardiomyopathy. Patients in group B seemed to be able to tolerate chronic anthracycline cardiac toxicity.