Review of tests for monitoring doxorubicin-induced cardiomyopathy

William I. Ganz, Kasi S. Sridhar, Susan S. Ganz, Rigoberto Gonzalez, Simon Chakko, Aldo N Serafini

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

The objective of this review is to make physicians aware of new radionuclide methods to detect cardiac effects of chemotherapeutic drugs. This knowledge is important because of the limitations of the physical examination and the electrocardiogram for detecting early reversible cardiac damage. Presently left ventricular ejection fraction (LVEF) is routinely used to screen for cardiotoxicity. Since LVEF obtained by radionuclide angiocardiography is more accurate than the LVEF estimated by echocardiography, serial radionuclide LVEF monitoring is most commonly used to monitor cardiotoxicity. Diastolic measurements of left ventricular function (such as peak filling rate) are now being added to routine LVEF measurements to enhance standard radionuclide evaluation. This screening test should be done prior to beginning therapy and at appropriate points based on the baseline study, therapy scheme and the patient's clinical status. At some centers, exercise LVEF methods are being used to determine if cardiac reserve is adequate for the patient to tolerate additional chemotherapy when cardiac injury may be present. Previously, endomyocardial biopsy was needed to detect and confirm early anthracycline cardiotoxicity. This invasive test may be replaced by a new noninvasive in vivo method using radioactive monoclonal antibodies against cardiac muscle (indium-111-antimyosin). Because cardiac failure has been associated with adrenergic neuron injury, it has been proposed that radioactive methyliodobenzylguanine may detect the adrenergic abnormality which may predict future development of congestive heart failure or sudden death months after therapy is discontinued, Advantages and disadvantages of these methods in evaluating cardiotoxicity, and an algorithm to optimally monitor antitumor therapy-induced cardiomyopathy are discussed.

Original languageEnglish
Pages (from-to)461-470
Number of pages10
JournalOncology
Volume53
Issue number6
StatePublished - Nov 1 1996

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Cardiomyopathies
Stroke Volume
Doxorubicin
Radioisotopes
Heart Failure
Angiocardiography
Adrenergic Neurons
Anthracyclines
Wounds and Injuries
Therapeutics
Sudden Death
Left Ventricular Function
Adrenergic Agents
Physical Examination
Echocardiography
Myocardium
Electrocardiography
Monoclonal Antibodies
Exercise
Physicians

Keywords

  • Cardiotoxicity
  • Doxorubicin
  • Ejection fraction, left ventricular
  • Peak filling rate

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ganz, W. I., Sridhar, K. S., Ganz, S. S., Gonzalez, R., Chakko, S., & Serafini, A. N. (1996). Review of tests for monitoring doxorubicin-induced cardiomyopathy. Oncology, 53(6), 461-470.

Review of tests for monitoring doxorubicin-induced cardiomyopathy. / Ganz, William I.; Sridhar, Kasi S.; Ganz, Susan S.; Gonzalez, Rigoberto; Chakko, Simon; Serafini, Aldo N.

In: Oncology, Vol. 53, No. 6, 01.11.1996, p. 461-470.

Research output: Contribution to journalArticle

Ganz, WI, Sridhar, KS, Ganz, SS, Gonzalez, R, Chakko, S & Serafini, AN 1996, 'Review of tests for monitoring doxorubicin-induced cardiomyopathy', Oncology, vol. 53, no. 6, pp. 461-470.
Ganz WI, Sridhar KS, Ganz SS, Gonzalez R, Chakko S, Serafini AN. Review of tests for monitoring doxorubicin-induced cardiomyopathy. Oncology. 1996 Nov 1;53(6):461-470.
Ganz, William I. ; Sridhar, Kasi S. ; Ganz, Susan S. ; Gonzalez, Rigoberto ; Chakko, Simon ; Serafini, Aldo N. / Review of tests for monitoring doxorubicin-induced cardiomyopathy. In: Oncology. 1996 ; Vol. 53, No. 6. pp. 461-470.
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