5-Fluorouracil increases the number and complexity of premature complexes in the heart: A prospective study using ambulatory ECG monitoring
| Autor: | Yilmaz, U., Oztop, I., Ciloglu, A., Okan, T., Tekin, U., Yaren, Arzu., Somali, I. |
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| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
Cardiac Complexes Premature drug safety loading drug dose digestive system cancer medical record review fluorouracil heart rate Prospective Studies heart ventricle extrasystole antineoplastic agent supraventricular premature beat Gastrointestinal Neoplasms clinical article stomach cancer cancer adjuvant therapy adult article adjuvant therapy clinical trial Middle Aged continuous infusion symptom Holter monitoring ambulatory monitoring aged patient assessment female esophagus cancer priority journal ST segment diabetes mellitus antihypertensive agent Antimetabolites Antineoplastic hypertension side effect folinic acid cardiotoxicity oral antidiabetic agent clinical observation multiple cycle treatment liver cancer heart enzyme cancer combination chemotherapy metastasis Humans human thorax pain heart rhythm Electrocardiography Ambulatory |
| Popis: | The cardiac toxicity of LV5FU2 (de Gramont) regimen which is a widely used chemotherapy regimen in gastrointestinal system cancers is not well defined. We aimed to evaluate the impact of this regimen on cardiac rhythm. Two Holter ECG recordings were obtained in all patients with gastrointestinal system cancers treated with LV5FU2 regimen as first-line chemotherapy (one before and the second during the first 24 h of chemotherapy). Records were reviewed for the heart rate, rhythm, atrial premature complexes (APC), ventricular premature complexes (VPC), grades according to Lown-Wolf grading system and ST segment changes. Holter ECG recordings were evaluated in 27 patients. In the baseline evaluation, neither clinical symptom nor ST segment changes were observed. During the treatment period, chest pain was observed in two patients without any cardiac enzyme and ST segment changes. Moreover, a decrease in mean heart rate, and an increase in the number and complexity of premature complexes secondary to treatment were observed. The mean heart rate, APC per hour and VPC per hour (±SD) before vs. during treatment were, respectively, 93.1 ± 16.4 vs. 81.6 ± 12.7 (p = 0.001), 18.9 ± 54.0 vs. 45.3 ± 53.8 vs. (p = 0.049) and 12.7 ± 29.6 vs. 38.1 ± 42.1 (p = 0.002). LV5FU2 regimen leads to a decrease in mean heart rate and a significant increase in APC and VPC which may lead to serious arrhythmias. These effects must be better understood for a safer administration of this useful and widely used drug regimen. © 2007 The Authors. |
| Databáze: | OpenAIRE |
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