Original articleUltrasonic analysis of anthracycline-induced myocardial damage using cyclic variation of integrated backscatter☆
Section snippets
Study population
Between April 1998 and September 2000, 126 patients with various hematologic malignancies were referred to our cardiology department for echocardiographic evaluation. In 12 patients, IB analyses were not completed because their images were not suitable. Complete IB data were obtained from 114 patients (90%). A total of 3 patients who had a history of heart failure were excluded. Of these patients, 32 patients with non-Hodgkin’s lymphoma (17 men, 15 women; age 52 ± 13 years) who had been treated
Interindividual comparison
As shown in Table 1 and Figure 1, patients with non-Hodgkin’s lymphoma in the low-dose group had been treated with 105 ± 60 mg/m2 of doxorubicin; in moderate-dose group with 297 ± 48 mg/m2; and in high-dose group with 529 ± 70 mg/m2. There was a progressive decrease in LV ejection fraction from 69% to 61% among 4 groups, which was still in the normal range and not statistically significant. This change seemed to be a result of small but gradual increase in LV systolic dimension. There were no
Discussion
In this study, CV-IB was blunted in patients with non-Hodgkin’s lymphoma who were treated with moderate doses of anthracyclines, although their conventional systolic and diastolic parameters were apparently not affected. This fact suggests that subclinical myocardial damage is already induced by moderate doses of anthracyclines and that noninvasive IB analysis can detect the early cardiotoxicity.
Acknowledgements
We would like to thank Drs Hirokazu Okumura and Shinji Nakao, the Department of Cellular Transplantation Biology, Graduate School of Medical Science, Kanazawa University, for the collection of the study patients.
This article is dedicated to the memory of Prof Kenichi Kobayashi, who died on November 3, 2002.
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Supported by a research grant from the Ministry of Education, Science, and Culture of Japan (No. 10770305).