Skip to main content
SpringerLink
Log in

Anthrazyklininduzierte Kardiomyopathie im Kindesalter

Pathogenese, Diagnostik und Therapie

Anthracycline-induced cardiomyopathy in childhood

Pathogenesis, diagnostics and therapy

  • Originalien
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Die anthrazyklininduzierte Kardiomyopathie (AIK) stellt ein Problem in der Langzeitbetreuung krebskranker Kinder dar. Verschiedene Pathomechanismen werden in diesem Beitrag diskutiert, eine multifaktorielle Genese ist wahrscheinlich. Die Echokardiographie erlangt in der Diagnostik einen wichtigen Stellenwert; Belastungsuntersuchungen weisen die höchste Sensitivität auf. Verschiedene Behandlungsprotokolle finden Anwendung, wobei sich die frühzeitige Therapie subklinischer Formen positiv auf die Langzeitprognose auswirkt.

Abstract

Anthracycline-induced cardiomyopathy is a major problem in the long-term follow-up of patients with childhood malignancies. Several pathomechanisms have to be discussed and a multifactorial genesis is most likely. Echocardiography is an important tool in diagnosing failing myocardium, whereas stress testing has the highest sensitivity. Several therapeutic options are recommended and early treatment of subclinical forms has a positive influence on the long-term prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Aggarwal S, Pettersen MD, Gurckzynski J, L’Ecuyer T (2007) Measuring stress-velocity index using mean blood presseure: simple yet accurate. Pediatr Cardiol 29:108–112

    Article  PubMed  Google Scholar 

  2. Alvarez JA, Scully RE, Miller TL et al (2009) Long-term effects of treatment for childhood cancers. Curr Opin Pediatr 19(1):23–31

    Article  Google Scholar 

  3. Amigoni M, Giannattasio C, Fraschini D et al (2010) Low anthracyclines doses-induced cardiotoxicity in acute lymphoblastic leukemia long-term female survivors. Pediatr Blood Cancer (published online 29)

  4. Barry E, Alvarez JA, Scully RE et al (2007) Anthracycline-induced cardiotoxicity: course, pathophysiology, preven-tion and Management. Expert Opin Pharmacother 8(8):1039–1058

    Article  PubMed  CAS  Google Scholar 

  5. Bernaba BN, Chan JB, Lai CK, Fishbein MC (2010) Pathology of late-onset anthracycline cardiomyopathy. Cardiovasc Pathol 19(5):308–311

    Article  PubMed  CAS  Google Scholar 

  6. Carvalho RA, Sousa RP, Cadate VJ et al (2010) Metabolic remodeling associated with subchronic doxorubicin cardiomyopathy. Toxicology 270(2–3):92–98

    Google Scholar 

  7. Davison G, Hall CS, Miller JC et al (1994) Cellular mechanism of captopril induced matrix remodelling in Syrian hamster cardiomyopathy. Circulation 90:1334–1342

    PubMed  CAS  Google Scholar 

  8. Deng S, Wojnowski L (2007) Genotyping the risk of anthrazycline-induced cardiotoxicity. Cardiovasc Toxicol 7:129–134

    Article  PubMed  CAS  Google Scholar 

  9. Elbl L, Hrstkova H, Chaloupka V (2003) The late consequences of anthracycline treatment on left ventricular function after treatment for childhood cancer. Eur J Pediatr 162(19):690–696

    Article  PubMed  CAS  Google Scholar 

  10. Franco V, Henkel JM, Miller TL, Lipshultz SE (2011) Cardiovascular effects in childhood cancer survivors treated with anthracyclines. Cardiol Res Pract 134679

  11. Fulbright JM, Huh W, Anderson P, Chandra J (2010) Can anthracycline therapy for pediatric malignancies be less cardiotoxic? Curr Oncol Rep 12(6):411–419

    Article  PubMed  Google Scholar 

  12. Gabizon AA, Lyass O, Berry GJ, Wildgust M (2004) Caridac safety of pegylated liposomal doxorubicin demonstrated by endomyocardial biopsy in patients with advanced malignancies. Cancer Invest 22(5):663–669

    Article  PubMed  CAS  Google Scholar 

  13. Geus-Oedl LF, Marvinkurve-Groothuis AM, Bellersen L et al (2011) Scintigraphic techniques for early detection of cancer treatment induced cardiotoxicity. J Nucl Med 52(2):560–571

    Article  Google Scholar 

  14. Hauser M, Gibson BS, Wilson N (2001) Diagnosis of anthracyline-induced late cardiomyopathy by exercise-spiroergometry and stress-echocardiography. Eur J Pediatr 160:607–610

    Article  PubMed  CAS  Google Scholar 

  15. Hauser M, Wilson N (2000) Anthracycline induced cardiomyopathy: successful treatment with angiotensin converting enzyme inhibitors. Eur J Pediatr 159(5):389

    Article  PubMed  CAS  Google Scholar 

  16. Hershko C, Pinson A, Link G (1969) Prevention of anthracycline cardiotoxicity by iron chelation. Acta Haematol 95(1):87–92

    Article  Google Scholar 

  17. Horacek JM, Tichy M, Jebavy L et al (2008) Use of multiple biomarkers for evaluation of anthracycline-induced cardiotoxicity in patients with AML. Exp Oncol 30(2):157–159

    PubMed  CAS  Google Scholar 

  18. Kalay N, Basar E, Ozdogru I et al (2006) Protective effects of carvedilol against anthracycline-induced cardiomyopathy. J Am Coll Cardiol 48(11):2258–2262

    Article  PubMed  CAS  Google Scholar 

  19. Karakurt C, Kocak G, Ozgen U (2008) Evaluation of the left ventricular function with tissue tracking and tissue Doppler echocardiography in pediatric malignancy survivors after anthracycline therapy. Echocardiography 25(8):880–887

    Article  PubMed  Google Scholar 

  20. Lewis W, Kleinermann J, Piszkin S (1982) Interaction of adriamycin in vitro with cardiac myofibrillar proteins. Circ Res 50(4):547–553

    PubMed  CAS  Google Scholar 

  21. Lipshultz SE (2006) Exposure to anthracyclines during childhood causes cardiac injury. Semin Oncol 33(3 Suppl 8):S8–S14

    Article  PubMed  CAS  Google Scholar 

  22. Lipshultz SE, Adams MJ (2010) Cardiotoxicity after childhood cancer: beginning with the end in mind. J Clin Oncol 28:1276–1281

    Article  PubMed  Google Scholar 

  23. Lipshultz SE, Lipsitz SR, Sallan SE et al (2005) Chronic progressive cardiac dysfunction years after doxorubicin therapy for childhood acute lymphoblastic leukemia. J Clin Oncol 23(12):2629–2636

    Article  PubMed  CAS  Google Scholar 

  24. Lipshultz SE, Scully RE, Lipsitz SR (2010) Assessment of dexrazoxan as a cardioprotectant in doxorubicin-treated children with high risk ALL: long trerm follow up of a prospective, randomised, multicentre trial. Lancet Oncol 11:950–961

    Article  PubMed  CAS  Google Scholar 

  25. Montaigne D, Marechal X, Baccouch R et al (2010) Stabilization of mitochondrial membrane potential prevents doxorubicin-induced crdiotoxicity in isolated rat heart. Toxicol Appl Pharmacol 244(3):300–307

    Article  PubMed  CAS  Google Scholar 

  26. Myers CE, Mc Guire WP, Liss RH (1977) Adriamycin: the role of lipid peroxidation in cardiac toxicity and tumor response. Science 19:165–167

    Article  Google Scholar 

  27. Paulides M, Wojnowski L (2007) Chemotherapeutics-induced heart failure. Med Klin (Munich) 102:574–578

    Google Scholar 

  28. Radulescu D, Pripon S, Radulecu LI, Duncea C (2008) Left ventricular diastolic performance in breast cancer survivors treated with anthracyclines. Acta Cardiol 63(1):27–32

    Article  PubMed  Google Scholar 

  29. Salzer WL, Devidas M, Carroll WL et al (2010) Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984–2001: a report from the children‘s oncology group. Leukemia 24(2):355–370

    Article  PubMed  CAS  Google Scholar 

  30. Santin JC, Deheinzelin D, Junior SP et al (2007) Late echocardiographic assessment of systolic and diastolic function of the left ventricle in pediatric cancer survivors after anthracycline therapy. J Pediatr Hematol Oncol 29(11):761–765

    Article  PubMed  CAS  Google Scholar 

  31. Scully RE, Lipshultz SE (2007) Anthracycline cardiotoxicity in long-term survivors in childhood cancer. Cardiovasc Toxicol 7(2):122–128

    Article  PubMed  CAS  Google Scholar 

  32. Tebbi CK, London WB, Friedman D et al (2007) Dexrazoxane-associated risk for acute myeloid leukaemia/myelodysplastic syndrome and other secondary malignancies in pediatric Hodgkin‘s disease. J Clin Oncol 25(5):493–500

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Lazarettstraße 36, 80636, München, Deutschland

    M. Hauser & J. Hess

  2. Abteilung Molekulare Pathologie, Institut für Pathologie, Universitätsklinikum Tübingen , Tübingen, Deutschland

    R. Kandolf

Authors
  1. M. Hauser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Kandolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Hess
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Hauser.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hauser, M., Kandolf, R. & Hess, J. Anthrazyklininduzierte Kardiomyopathie im Kindesalter. Monatsschr Kinderheilkd 160, 129–134 (2012). https://doi.org/10.1007/s00112-011-2541-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-011-2541-0

Schlüsselwörter

Keywords

Search

Navigation