ASSESSMENT OF EARLY EPIRUBICIN CARDIOTOXICITY IN WOMEN WITH BREAST-CANCER

Background: Anthracycline-containing chemotherapy has been the most fr equently observed cause of iatrogenic cardiac damage in patients with breast cancer. The purpose of this study was to evaluate by radionucli de ventriculography whether a mean cumulative dose of epirubicin (MCDE ) induced left ventricular (LV) systolic or/and diastolic dysfunction in 32 patients treated for breast cancer. Materials and methods: Thirt y-two patients with breast cancer according to chemotherapeutical tria ls received MCDE of 360 m/m(2). All patients were studied before and a fter they completed chemotherapy with radionuclide ventriculography at rest. Systolic and diastolic left ventricular parameters were assesse d. Results: Diastolic left ventricular parameters and R-R intervals si gnificantly differed before and after completed chemotherapy in outpat ients: peak filling rate (PFR: 2.8 +/- 0.6 vs. 2.2 +/- 0.7 EDV/sec) an d time to filling rate (TPFR: 182 +/- 48 vs. 2.25 +/- 50 msec), R-R: 7 23 +/- 51 vs. 620 +/- 45 msec, p <0.01. Ejection fraction, as a systol ic parameter/did not significantly differ before and after completed c hemotherapy (EF: 59 +/- 7 vs. 58 +/- 6 %), p > 0.05. Conclusion: Our r esults indicate that left ventricular diastolic dysfunction even at an MCDE of 360 mg/m(2) may be an early sign of epirubicin cardiotoxicity .