Title: Cardiotoxicity of Doxorubicin –A Prospective Study
Authors: Jayaprakash Kesavapillai, S.Abdul Khader, Raju George, V.L.Jayaprakash, Raihanathul Misiriya
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.109
Abstract
Therapeutic strategy in malignancy involves use of various chemotherapeutic agents, radiation and surgery, either alone or in combination. Doxorubicin (Adriamycin) is a powerful drug in the fight against cancer. Cardiotoxicity is a major adverse effect of doxorubicin. Aim of the present study is to evaluate the profile of subacute and chronic cardiac toxicity of doxorubicin used for chemotherapy of various malignant neoplastic disorders. 100 consecutive patients referred to Cardiology Department for evaluation prior to chemotherapy with doxorubicin were enrolled in the study. Baseline and follow-up echocardiographic evaluation was carried out by two dimensional, M mode and Doppler assessment using standard transthoracic views. ECG was carefully examined for any arrhythmias, ST-T changes, conduction defects or other abnormalities. After completion of chemotherapy, patients were called for review for evaluation of cardiac status. Decline in ejection fraction after chemotherapy was observed in 39 patients, ranging up to 36% reduction compared to the baseline value. >10% decline in ejection fraction was observed in 19 patients and >15% reduction in 11 patients. The mean ejection fraction before chemotherapy was 73.95% and the mean value after treatment was 70.15%. The difference between these two was statistically significant (p=0.00039). Effect of adriamycin-based chemotherapy on Tei index was assessed. The mean value of Tei index showed no significant difference before and after treatment (0.45 vs. 0.48, p=NS). Electrocardiographic abnormalities like Brugada pattern (3% cases) and QTc prolongation (3% cases) were observed following administration of doxorubicin.
Keywords: Cardiotoxicity, Anthracycline, Echocardiography, Ejection fraction.
