IMPAIRMENT OF DIASTOLIC FUNCTION DURING SHORT-TERM ANTHRACYCLINE CHEMOTHERAPY

Objective-To assess the early changes in left ventricular diastolic an d systolic function due to anthracycline treatment. Design-A prospecti ve study of cardiac function by radionuclide angiography in adults bef ore and one month after the end of anthracycline treatment. Patients-6 0 patients without cardiac disease treated with chemotherapy containin g anthracycline. Methods-Cardiac function was assessed by radionuclide measurement throughout treatment. Ejection fraction, peak ejection ra te, time to peak ejection rate, filling rate, and time to peak filling rate were measured before and after treatment, To normalise radionucl ide measurements of the left ventricular diastolic function the ratio of the filling rate to the ejection fraction and the ratio of the fill ing rate to the peak ejection rate were calculated. Results-No patient developed symptomatic congestive cardiac failure. ejection fi action decreased from (5%) to 55% (6%) (P < 0.001), the peak ejection rate fe ll from 2.99 (0.41) to 2.77 (0.41) of the end diastolic volume per sec ond (P < 0.001), and the peak filling rate from 2.71 (0.47) to 2.55 (0 .44) of the end diastolic volume per second (P < 0.01) after treatment . No difference was observed in the normalised ratios. Conclusions-Thi s report shows simultaneous impairment of left ventricular systolic an d diastolic radionuclide parameters. The absence of variation in norma lised measurements suggests similar changes in ejection fraction, peak ejection rate, and peak filling rate throughout treatment.