The Clinical Value of Echocardiography and Acoustic Cardiography to Monitor Patients Undergoing Anthracycline Chemotherapy. Issue 4 (14th November 2012)

• Record Type: Journal Article
• Authors: Toggweiler, Stefan; Odermatt, Yvonne; Brauchlin, Andreas; Zander, Thilo; Müller, Andrea; Zuber, Michel; Winterhalder, Ralph; Erne, Paul
• Is Part Of: Clinical cardiology. Volume 36:Issue 4(2013:Apr.)
• Page Start: 201
• Page End: 206
• Publication Date: 2012-11-14
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22074
• Languages: English
• ISSNs: 0160-9289

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background</title> <p>Investigate the usefulness of echocardiography and acoustic cardiography to monitor patients exposed to anthracycline chemotherapy.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Hypothesis</title> <p>Serial echocardiographies to monitor systolic function may not be neccessary in all patients undergoing anthracycline chemotherapy.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Methods</title> <p>In a prospective study, consecutive patients undergoing anthracycline‐containing chemotherapy were evaluated with echocardiography and acoustic cardiography at baseline, after completion of chemotherapy, and after a median follow‐up of 3.8 years. Systolic dysfunction was defined as a left ventricular ejection fraction ≤50%.</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Results</title> <p>A total of 187 patients (83% female) with a mean age of 55 ± 14 years underwent chemotherapy for breast cancer (73%), malignant lymphoma (23%), and sarcoma (4%). None of the patients had systolic dysfunction at baseline. Patients were treated with doxorubicin 276 ± 74 mg/m<sup>2</sup> or epirubicin 317 ± 55 mg/m<sup>2</sup>. After chemotherapy, 170 (91%) had normal systolic function, 8 (4%) developed systolic dysfunction, and 9 (5%) had died. Of those 8 patients with systolic dysfunction, 4 (50%) improved to normal systolic function, 1 (13%) remained unchanged, and 3 (37%) died. Patients with normal systolic function after chemotherapy had a mortality rate of 3.5%, and 1.8% developed late systolic dysfunction. Acoustic cardiography‐derived percent electromechanical activation time >12.4% had a sensitivity of 88% and a specificity of 84% to identify patients with systolic dysfunction (area under the receiver operating characteristic curve 0.87).</p> </sec> <sec id="abs1-5" sec-type="section"> <title>Conclusions</title> <p>Patients with systolic dysfunction early after anthracycline treatment had worse outcome. Acoustic cardiography was able to identify these patients with a high sensitivity and specificity. Based on the findings of this study, we propose a simple algorithm to monitor patients undergoing anthracycline‐containing chemotherapy.</p> <p>The authors have no funding, financial relationships, or conflicts of interest to disclose.</p> </sec> </abstract>