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- W2242817055 abstract "20517 Background: Anthracycline-induced cardiotoxicity is potentially fatal and can impair patient quality of life: it increases exponentially with cumulative dose and its early detection is crucial to prevent clinical heart failure (HF). Methods: A phase II, open, non randomized trial. Inclusion criteria: patients 18–70 y, histologically confirmed cancer, previously untreated and candidates for an EPI-based regimen; LVEF ≥ 55%; ECOG PS 0–2, no history of cardiac disease, hypertension, diabetes mellitus and previous mediastinal irradiation. Conventional echocardiography as well as TDI with Strain (Σ) and Strain Rate (SR) (a very accurate technique in detecting minimal changes in the cardiac left ventricular (LV) function), circulating levels of biochemical markers of both myocardial damage and inflammation/oxidative stress were assessed at baseline, 24 hours and 7 days at a cumulative EPI dose of 100, 200, 300, and 400 mg/m2, respectively. Aim of the study: to detect early preclinical changes predictive of the risk for HF and compare them with biochemical/inflammatory markers. Results: 16 patients were enrolled. A significant impairment of the systolic LV function was observed at EPI 200 mg/m2: the SR peak decreased significantly (p<0.001) whereas the Σ remained unchanged. Significant changes of LV diastolic function by TDI occurred only at EPI 300 mg/m2: a decrease of conventional E/A (p=0.02), Em wave (p=0.03) and Em/Am ratio (p=0.002) without significant changes of LVEF. IL-6, sIL-6R and ROS increased, whilst GPx decreased significantly at EPI 200 mg/m2. A significant correlation (by Pearson’s t-test) between the SR peak decrease (ΔSR) at EPI 200 mg/m2, increase of IL-6/ROS (p=0.0031 and p=0.0002, respectively) and decrease of GPx (p=0.03) was observed. The multiple regression analysis showed that only ROS level was predictive of ΔSR (p=0.0167). Conclusions: Subtle cardiac abnormalities may occur at EPI doses significantly below those potentially clinically harmful. Earliest myocardial impairment affects the LV systolic rather than diastolic function and was associated with high ROS and inflammation markers. A higher sample size may allow to show the clinical meaningfulness of our study. No significant financial relationships to disclose." @default.
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- W2242817055 date "2008-05-20" @default.
- W2242817055 modified "2023-09-26" @default.
- W2242817055 title "Early epirubicin (EPI)-induced myocardial dysfunction revealed by serial tissue doppler imaging (TDI): Correlation with inflammatory and oxidative stress markers" @default.
- W2242817055 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.20517" @default.
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