technetium-tc-99m-stannous-pyrophosphate and Neoplasms

Results of 606 equilibrium radionuclide ventriculographies performed in 348 non-selected patients receiving Adriamycin (ADM) therapy were stored in a data base system. The aim of the study was to assess the influence of a potential cardiotoxic therapy on left ventricular pump function. Increasing ADM doses yielded a significant (p less than 0.05) decrease of the resting ejection fraction (R-gEF), the peak ejection rate and the peak filling rate. End diastolic and end systolic volumes increased significantly. Stroke volume, heart rate and time to peak filling rate did not change significantly. 368 follow-up studies were performed in 128 patients: 65/128 patients presented a decrease of R-gEF, but only in 45 of these patients R-gEF values fell into the pathologic range. In 44 of these follow-ups, R-gEF remained unchanged. In 19 patients, a R-gEF increase was observed. At the beginning of ADM therapy 14% of the patients had subnormal R-gEF values. With increasing ADM doses pathologic findings increased to 86% in patients with ADM doses higher than 500 mg/m2.

Topics: Adult; Doxorubicin; Erythrocytes; Female; Heart; Heart Function Tests; Hemodynamics; Humans; Male; Middle Aged; Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates

The aim of the study was to evaluate the influence of a cardiotoxic therapy with Adriamycin (ADM) on left ventricular pump function. In 348 patients with malignant tumors, 606 equilibrium radionuclide ventriculographies (ERNV) were performed. In 90 patients, resting studies (R-ERNV) were followed by studies during exercise (E-ERNV). Results were evaluated statistically to determine whether E-ERNV provides more reliable parameters in the early detection of Adriamycin cardiomyopathy (ADM-CMP) than R-ERNV. The following left ventricular parameters were evaluated: global ejection fraction (gEF); end diastolic, end systolic, stroke volume (EDV, ESV, SV); peak filling rate, peak ejection rate (pFR, pER); time to peak filling rate (TpFR) and heart rate. Increasing ADM doses yielded a significant decrease (p less than 0.05) of resting values of gEF, pER, pFR. In contrast, stress-induced increases of gEF, pER, pFR were found independent of accumulative ADM doses and independent of the resting values of these parameters. An increase of gEF resulted from a significant decrease of ESV. In most cases, pathologic results at rest were detected earlier than subnormal changes of exercise values. Therefore, E-ERNV does not have a significantly higher sensitivity in the early detection of ADM-CMP than R-ERNV and is not required for the surveillance of patients under ADM therapy.

Topics: Adult; Doxorubicin; Erythrocytes; Female; Heart; Heart Function Tests; Hemodynamics; Humans; Male; Middle Aged; Neoplasms; Physical Exertion; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates