[Usefulness of stress echocardiography for early diagnosis of anthracycline-induced cardiomyopathy].
BACKGROUND: Early evidence of drug induced cardiomyopathy is of great importance in oncological treatment, especially for application of Anthrazyklines. Stress echocar-diography (SE) has been proven to be of value in determining left ventricular function at rest and under stress. This study was performed to investigate the cardiac function under Anthrazykline-chemotherapy (aCT). PATIENTS AND METHODS: Patients with malignant thoracic tumors and indication for aCT underwent pharmacological SE (infusion of increasing dobutamin-doses, 5 microgram/kg/bw in 3 minute-steps) before starting aCT. Left ventricular ejection fraction (LVEF) and wall motion were measured. If the tumor decreased and the patients underwent 4 or more cycles of CT, at the end of the last CT another SE investigation was performed. RESULTS: 30 patients (20 men, 15 women; mean age 52, range 28 - 71) were included and the data were compared. Before aCT the mean LVEF was 59 % at rest and 71 % at maximum load, no disturbances of wall motion could be observed. After the end of aCT (mean dose 408 mg, range 256 - 549; mean 4.4 cycles, range 4 - 7) the LVEF was 58 at rest and 68 at maximum load (not significant) and there were also no disturbances of motion. CONCLUSION: SE is an alternative to echocardiography at rest in assessment of left ventricular function in patients receiving Anthrazykline-CT. With the doses applied no patient developed cardiomyopathy. So we consider SE a cost-effective method and safe for patients.