Pathology & Oncology Research

, Volume 14, Issue 1, pp 69–77 | Cite as

Early Diagnosis of Chemotherapy-induced Cardiomyopathy: a Prospective Tissue Doppler Imaging Study

  • András Csaba NagyEmail author
  • Zsuzsanna Cserép
  • Edina Tolnay
  • Tamás Nagykálnai
  • Tamás Forster
Original Paper


The aim of our study was to compare the applicability of the conventional echocardiography and a novel method, tissue Doppler imaging (TDI) in detection of late or subclinical cardiotoxicity following anthracycline chemotherapy in long-term follow up. Forty women (31 to 65 years) were enrolled, who had not received anthracyclines previously and had normal cardiac function. The control group consisted of 20 healthy persons of similar age range. In addition to standard echocardiographic measurements, each patient underwent specific measurements (E-septum separation, pulmonary venous flow) as well. Furthermore, the myocardial velocity of numerous segments of the mitral anulus obtained with pulsed wave TDI was also detected over a two-year-long period. Systolic left ventricular function did not change significantly either in the study or in the control group. After one year, diastolic left ventricular function was impaired in 39 patients (97.5%), and 29 (72.5%) of these showed clear changes by means of the traditional E/A ratio and TDI. However, in ten patients (25%) the diastolic dysfunction could only be detected with TDI. At the end of the study diastolic dysfunction was detected in each patient, but in 13 patients (32.5%) the relaxation disorder could be revealed only with TDI. Detectable myocardial damage occurred in the study group as a result of anthracycline therapy. Our results confirmed our assumptions that TDI is a more precise and useful examination method than the traditional ones (E/A ratio or deceleration time) to demonstrate isolated diastolic dysfunction. TDI may become a regularly and more widely used noninvasive method to detect subclinical cardiotoxicity emerging after chemotherapy.


Anthracycline Tissue Doppler imaging Cardiotoxicity 



doxorubicin and cyclophosphamide


epirubicin and cyclophosphamide




ejection fraction

IVSs and IVSd

thicknesses of the left ventricular septum in systole and in diastole


thicknesses of the left ventricular posterior wall in systole and in diastole


left ventricular end-diastolic dimension in systole and in diastole


tissue Doppler imaging


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Copyright information

© Arányi Lajos Foundation 2008

Authors and Affiliations

  • András Csaba Nagy
    • 1
    Email author
  • Zsuzsanna Cserép
    • 2
  • Edina Tolnay
    • 3
  • Tamás Nagykálnai
    • 4
  • Tamás Forster
    • 5
  1. 1.1st Department of Internal Medicine and CardiologyUzsoki Municipal HospitalBudapestHungary
  2. 2.Semmelweis UniversityBudapestHungary
  3. 3.2nd DepartmentPest County Institute of PulmonologyTörökbálintHungary
  4. 4.Oncoradiological CentreUzsoki Municipal HospitalBudapestHungary
  5. 5.2nd Department of Internal Medicine and Cardiological Centre, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Faculty of MedicineUniversity of SzegedSzegedHungary

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