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Sequential evaluation of left ventricular myocardial performance in children after anthracycline therapy

      The anthracycline antibiotics are important components of many antineoplastic chemotherapeutic regimens. The sequential monitoring of cardiac function of patients undergoing chemotherapy allows the identification of subclinical cardiotoxicity. Such cardiotoxicity is related to the cumulative dose of these drugs; the risk of congestive heart failure in children has been reported to increase at cumulative doses of >550 mg per body surface area.
      • Steinherz L.J.
      • Graham T.
      • Hurwitz R.
      • Sondheimer H.M.
      • Schwartz R.G.
      • Shaffer E.M.
      • Sandor G.
      • Benson L.
      • Williams R.
      Guidelines for cardiac monitoring of children during and after anthracycline therapy report of the cardiology committee of the childrens’ cancer study group.
      ,
      • Shan K.
      • Lincoff M.
      • Young J.B.
      Anthracycline-induced cardiotoxicity.
      To our knowledge, little has been published on the effects of moderate doses of anthracycline antibiotics on left ventricular myocardial performance in clinically asymptomatic children treated for malignant neoplasms. Recently, an easily measured new Doppler index of left ventricular myocardial performance that combines systolic and diastolic time intervals known as the Tei index was proposed.
      • Tei C.
      New non-invasive index for combined systolic and diastolic ventricular function.
      ,
      • Tei C.
      • Ling L.H.
      • Hodge D.O.
      • Bailey K.R.
      • Oh J.K.
      • Rodeheffer R.J.
      • Tajik A.J.
      • Seward J.B.
      New index of combined systolic and diastolic myocardial performance a simple and reproducible measure of cardiac function—a study in normal and dilated cardiomyopathy.
      This index allows assessment of cardiac “reserve” and enables earlier detection of myocardial dysfunction. It has previously been correlated with severity and clinical outcome in adult
      • Tei C.
      New non-invasive index for combined systolic and diastolic ventricular function.
      ,
      • Tei C.
      • Ling L.H.
      • Hodge D.O.
      • Bailey K.R.
      • Oh J.K.
      • Rodeheffer R.J.
      • Tajik A.J.
      • Seward J.B.
      New index of combined systolic and diastolic myocardial performance a simple and reproducible measure of cardiac function—a study in normal and dilated cardiomyopathy.
      ,
      • Tei C.
      • Dujardin K.S.
      • Hodge D.O.
      • Kyle R.A.
      • Tajik A.J.
      • Seward J.B.
      Doppler index combining systolic and diastolic myocardial performance clinical value in cardiac amyloidosis.
      and pediatric patients with congenital or acquired heart disease.
      • Eidem B.W.
      • Tei C.
      • O’Leary P.W.
      • Cetta F.
      • Seward J.B.
      Nongeometric quantitative assessment of right and left ventricular function myocardial performance index in normal children and patients with Ebstein anomaly.
      ,
      • Eto G.
      • Ishii M.
      • Tei C.
      • Tsutsumi T.
      • Akagi T.
      • Kato H.
      Assessment of global left ventricular function in normal children and dilated cardiomyopathy.
      ,
      • Tsutsumi T.
      • Ishii M.
      • Eto G.
      • Hota M.
      • Kato H.
      Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index.
      ,
      • Ishii M.
      • Eto G.
      • Tei C.
      • Tsutsumi T.
      • Hashino K.
      • Sugahara Y.
      • Himeno W.
      • Muta H.
      • Furui J.
      • Akagi T.
      • Fukiyama R.
      • Toyoda O.
      • Kato H.
      Quantitation of the global right ventricular function in children with normal heart and congenital heart disease a right ventricular myocardial performance index.
      This study prospectively evaluated the Tei index for detecting subclinical cardiotoxicity in patients undergoing chemotherapy.
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      References

        • Steinherz L.J.
        • Graham T.
        • Hurwitz R.
        • Sondheimer H.M.
        • Schwartz R.G.
        • Shaffer E.M.
        • Sandor G.
        • Benson L.
        • Williams R.
        Guidelines for cardiac monitoring of children during and after anthracycline therapy.
        Pediatrics. 1992; 89: 942-949
        • Shan K.
        • Lincoff M.
        • Young J.B.
        Anthracycline-induced cardiotoxicity.
        Ann Intern Med. 1996; 125: 47-58
        • Tei C.
        New non-invasive index for combined systolic and diastolic ventricular function.
        J Cardiol. 1995; 26: 135-136
        • Tei C.
        • Ling L.H.
        • Hodge D.O.
        • Bailey K.R.
        • Oh J.K.
        • Rodeheffer R.J.
        • Tajik A.J.
        • Seward J.B.
        New index of combined systolic and diastolic myocardial performance.
        J Cardiol. 1995; 26: 357-366
        • Tei C.
        • Dujardin K.S.
        • Hodge D.O.
        • Kyle R.A.
        • Tajik A.J.
        • Seward J.B.
        Doppler index combining systolic and diastolic myocardial performance.
        J Am Coll Cardiol. 1996; 28: 658-664
        • Eidem B.W.
        • Tei C.
        • O’Leary P.W.
        • Cetta F.
        • Seward J.B.
        Nongeometric quantitative assessment of right and left ventricular function.
        J Am Soc Echocardiogr. 1998; 11: 849-856
        • Eto G.
        • Ishii M.
        • Tei C.
        • Tsutsumi T.
        • Akagi T.
        • Kato H.
        Assessment of global left ventricular function in normal children and dilated cardiomyopathy.
        J Am Soc Echocardiogr. 1999; 12: 1058-1064
        • Tsutsumi T.
        • Ishii M.
        • Eto G.
        • Hota M.
        • Kato H.
        Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index.
        Pediatr Int. 1999; 41: 722-727
        • Ishii M.
        • Eto G.
        • Tei C.
        • Tsutsumi T.
        • Hashino K.
        • Sugahara Y.
        • Himeno W.
        • Muta H.
        • Furui J.
        • Akagi T.
        • Fukiyama R.
        • Toyoda O.
        • Kato H.
        Quantitation of the global right ventricular function in children with normal heart and congenital heart disease.
        Pediatr Cardiol. 2000; 21: 416-421
        • Hashimoto I.
        • Ichida F.
        • Miura M.
        • Okabe T.
        • Kanegane H.
        • Uese K.
        • Hamamichi Y.
        • Misaki T.
        • Koizumi S.
        • Miyawaki T.
        Automatic border detection identifies subclinical Anthracycline cardiotoxicity in children with malignancy.
        Circulation. 1999; 99: 2367-2370
        • Wolk M.J.
        • Keefe J.F.
        • Bing O.H.L.
        • Finkelstein L.J.
        • Levine H.J.
        Estimation of V maxiauxotonic systoles from the rate of relative increase of isovolumic pressure.
        J Clin Invest. 1971; 50: 1276-1285
        • Papapietro S.E.
        • Coghlan H.C.
        • Zissermann D.
        • Russell Jr, R.O.
        • Rackley C.E.
        • Roger W.J.
        Impaired maximal rate of left ventricular relaxation in patients with coronary artery disease and left ventricular dysfunction.
        Circulation. 1979; 59: 984-991
        • Weissler A.M.
        The heart in heart failure.
        Ann Intern Med. 1968; 69: 929-940