Journal
AMERICAN JOURNAL OF CARDIOLOGY
Volume 107, Issue 3, Pages 472-477Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2010.09.048
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Funding
- Madou Sin-Lau Hospital
- Presbyterian Church in Taiwan
- Inger and John Fredriksen Foundation
- South-Eastern Norway Regional Health Authority
- Norwegian Research Council
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Anthracycline therapy is well known for its adverse cardiac effects. However, few studies have been performed of the long-term follow-up of myocardial function in adult survivors of Hodgkin's lymphoma receiving anthracycline. Two-dimensional speckle tracking echocardiography is an accurate angle-independent modality for the quantification of left ventricular (LV) function. The aim of the present study was to investigate the long-term effect of anthracycline on LV systolic function. Echocardiography was performed in 47 survivors of Hodgkin's lymphoma 22 +/- 2 years after successful mediastinal radiotherapy with (n = 27) or without (n = 20) anthracycline (doxorubicin) treatment and in 20 healthy. controls. LV function was assessed by the LV ejection fraction and global longitudinal and circumferential strain. Both patient groups had received a similar dosage of radiation, and doxorubicin was given at a total dose of 309 +/- 92 mg. The global longitudinal strain was reduced in patients receiving anthracycline with mediastinal radiotherapy compared to the other group receiving mediastinal radiotherapy alone or combined radiotherapy and regimens without anthracyclines (-16.1 +/- 1.9% vs -17.5 +/- 1.7%, respectively, p < 0.05). Both patient groups had reduced strain compared to the healthy controls (-20.4 +/- 1.7%, both p < 0.001). The circumferential strain was also reduced in the treatment groups (-18.3 +/- 3.2% and -17.8 +/- 3.6% vs -22.5 +/- 2.1%, both p < 0.001). The LV ejection fraction did not differ between the patient groups (55 +/- 8% vs 56 +/- 6%; p = 1.0) but was reduced compared to that of the controls (62 +/- 5%, both p < 0.05). In conclusion, myocardial function was reduced in the survivors of Hodgkin's lymphoma 2 decades after successful treatment consisting of mediastinal radiotherapy with or without chemotherapy. Patients receiving anthracycline therapy had additional negative long-tern effects on LV systolic function. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:472-477)
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