STRESS ECHOCARDIOGRAPHY COMPARED WITH RAD IONUCLIDE VENTRICULOGRAPHY IN THE DIAGNOSIS OF CARDIOMYOPATHY IN PATIENTS RECEIVING CHEMOTHERAPY FOR MALIGNANT-TUMOR

Background and objective: Early evidence of drug-induced cardiomyopath y (CMP) is of great importance in haematological treatment, especially with anthracyclines. Stress echocardiography (SEC) has proved of valu e in determining left ventricular function at rest and under stress in patients with heart disease. The study was undertaken to assess the v alue of SEC in comparison with radionuclide ventriculography (RNV). Pa tients and methods: 63 unselected patients with malignant tumour (20 w omen, 43 men; mean age 49 +/- 15 years) underwent SEC and RNV. No chem otherapy had yet been started in 17 of them, 43 had received anthracyc lines as main component of the chemotherapy (mean anthracycline dose 3 39 +/- 251 mg/m(2)). Left ventricular ejection fraction (LVEF) was mea sured by both SEC and RNV at rest and during standardized stress (recu mbent ergometry). Both methods were applied and results measured indep endently by two examiners. Results: The time interval between the two tests averaged 1 +/- 2 days. EC could be performed at rest in 62 of 63 and under stress in 59 of 63 patients (RNV: 63 of 63 and 54 of 63, re spectively). Resting LVEF was 61 +/- 8% by SEC and 64 +/- 9% by RNV (P < 0.05). LVEF during stress, measured by SEC, was 71 +/- 11% and 73 /- 10% by RNV (not significant). Mean LVEF increase between rest and s tress was 9 +/- 10% by SEC and 9 +/- 8% by RNV (not significant). Conc lusion: SEC is a satisfactory alternative to RNV in the assessment of ventricular function in patients receiving chemotherapy. It is less in volved and more cost-effective than RNV, avoids radiation exposure and provides additional information on heart size and segmental contracti on abnormalities.