Lack of clinically significant cardiac dysfunction during intermediate dobutamine doses in long-term childhood cancer survivors exposed to anthracyclines

Autor: Maurizio Aricò, Catherine Klersy, Grazia Bossi, Maria Luisa Laudisa, Luca Lanzarini
Rok vydání: 2000
Předmět:
Zdroj: American Heart Journal. 140:315-323
ISSN: 0002-8703
DOI: 10.1067/mhj.2000.108237
Popis: Background Long-term survivors of childhood cancer treated with anthracyclines may have subclinical cardiac dysfunction undetectable at a baseline evaluation. Dobutamine stress echocardiography has been proposed as a more sensitive screening test, but results of previous studies were influenced by selection criteria, infusion protocols, and side effects. Methods We applied a modified dobutamine stress test (from 5 to 10 to 15 μg/kg, infused over a 5-minute period) and evaluated the influence on stress test results of reported risk factors for late cardiac toxicity (female sex, younger age at treatment, higher dose of anthracycline, and longer duration of follow-up). Seventy-one patients (46 male, mean age 15 ± 5 years) treated with anthracyclines (median dose 240 mg/m2) 1 to 16.5 years before and 20 controls (patients’ siblings: 12 male, mean age 19 ± 4 years) were studied. Results No major side effects were recorded. One patient was unable to perform the test because of anxiety. Limiting side effects were infrequent (3%) and occurred at a dobutamine dose of ≥10 μg/kg, when significant changes of hemodynamic and echocardiographic parameters were detectable in all cases. Rest systolic and mean blood pressure and left ventricular fractional shortening were significantly lower in patients than in controls (P
Databáze: OpenAIRE
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