DIMINISHMENT OF RESPIRATORY SINUS ARRHYTHMIA FORESHADOWS DOXORUBICIN-INDUCED CARDIOMYOPATHY

被引:32
作者
HRUSHESKY, WJM
FADER, DJ
BERESTKA, JS
SOMMER, M
HAYES, J
COPE, FO
机构
[1] UNION UNIV,DEPT VET AFFAIRS MED CTR,DEPT MICROBIOL IMMUNOL,ALBANY,NY 12208
[2] RENSSELAER POLYTECH INST,DEPT CHEM ENGN,TROY,NY 12181
[3] GEORGE WASHINGTON UNIV,SCH MED,WASHINGTON,DC 20052
[4] HENNEPIN CTY MED CTR,DEPT OPHTHALMOL,MINNEAPOLIS,MN 55415
[5] MIT,DEPT BRAIN & COGNIT SCI,CAMBRIDGE,MA 02139
[6] ROSS LABS,MED NUTR RES,COLUMBUS,OH
关键词
RESPIRATORY SINUS ARRHYTHMIA; CARDIOMYOPATHIES; DOXORUBICIN;
D O I
10.1161/01.CIR.84.2.697
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. The development of a microcomputer-based device permits quick, simple, and noninvasive quantification of the respiratory sinus arrhythmia (RSA) during quiet breathing. Methods and Results. We prospectively and serially measured the radionuclide left ventricular ejection fraction and the RSA amplitude in 34 cancer patients receiving up to nine monthly bolus treatments with doxorubicin hydrochloride (60 mg/m2). Of the eight patients who ultimately developed symptomatic doxorubicin-induced congestive heart failure, seven (87.5%) demonstrated a significant decline in RSA amplitude; five of 26 subjects without clinical symptoms of cardiotoxicity (19.2%) showed a similar RSA amplitude decline. On average, significant RSA amplitude decline occurred 3 months before the last planned doxorubicin dose in patients destined to develop clinical congestive heart failure. Conclusion. Overall, RSA amplitude abnormality proved to be a more specific predictor of clinically significant congestive heart failure than did serial resting radionuclide ejection fractions.
引用
收藏
页码:697 / 707
页数:11
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