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Ventricular repolarization time indexes following anthracycline treatment

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Summary

The anthracyclines, doxorubicin and daunorubicin, are antibiotics effective in the treatment of many malignancies. However, their usefulness is limited by the development of potentially fatal cardiotoxicity. Cardiac monitoring by a nonivasive test capable of identifying patients at high risk of cardiac damage, before the ejection fraction deteriorates would have clinical utility. Electrocardiograms and echocardiograms are routinely utilized for noninvasive assessment of myocardial function. However, of the ECG abnormalities described, none has been noted to be of consistent predictive value for cardiotoxicity. The aim of this study was to assess the effects of doxorubicin on ventricular repolarization time indexes, as they have been shown to be effective in the identification of electrical myocardial instability and, hence, in the identification of risk for either arrhythmia or heart failure. For this reason, electrocardiograms were compared in 35 cancer patients at the first presentation (drug-free state) and after 29.4±37.65 weeks of treatment with doxorubicin. The results of the present study showed that after only a short period of treatment with doxorubicin there was a significant increase in ventricular recovery time dispersion indexes (QTc, JT, and JTc dispersion, and their “adjusted” values). Thus, increased regional variation in ventricular repolarization could be, in the absence of a significant modification of the echocardiographic parameters, an early marker of an electropathy, due to the early cardiotoxic action of doxorubicin on myocardial cells, eventually leading to heart failure.

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Authors and Affiliations

  1. Cattedra di Cardiologia, Seconda Università degli Studi di Napoli Istituto Medico-Chirurgico di Cardiologia, Italy

    Berardo Sarubbi, Valentino Ducceschi, Lucio Santangelo, Francesco Ciaramella, Giuseppe Catalano & Aldo Iacono

  2. Dipartimento di Internistica Clinica e Sperimentale “F. Magrassi”, Cattedra e Servizio di Oncologia Medica, Napoli, Italy

    Michele Orditura & Fernando De Vita

Authors
  1. Berardo Sarubbi
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  2. Michele Orditura
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  3. Valentino Ducceschi
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  4. Fernando De Vita
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  5. Lucio Santangelo
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  6. Francesco Ciaramella
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  7. Giuseppe Catalano
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  8. Aldo Iacono
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Sarubbi, B., Orditura, M., Ducceschi, V. et al. Ventricular repolarization time indexes following anthracycline treatment. Heart Vessels 12, 262–266 (1997). https://doi.org/10.1007/BF02766801

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  • DOI: https://doi.org/10.1007/BF02766801

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