Diastolic or systolic left and right ventricular impairment at moderate doses of anthracycline? A 1-year follow-up study of women

A prospective study was carried out to assess the early and later alterations in left and right ventricular diastolic and systolic function after the termination of anthracycline therapy. In 33 women without cardiac disease who were treated by anthracycline therapy, cardiac function was evaluated by radionuclide angiography before the treatment (T-0) and 1 month (T-1) and 12 months (T-12) after the end of the treatment. Cardiac function was assessed by radionuclide measurement throughout treatment. Analysis of ejection fraction (EF), peak ejection rate (PER), time to PER (TPER), peak filling rate (PFR) and time to PFR (TPFR) was performed before and after treatment. To normalise radionuclide measurements of the ventricular diastolic function, the ratio of the PFR and the EF and the ratio of the PFR and the PER were calculated. No patient developed symptomatic congestive cardiac failure. One-way analysis of variance showed a significant decrease in the three parameters (EF, PER, PFR) over time only for the left ventricle (LV); no significant alterations appeared for the right ventricle (RV). The EF of the LV decreased from 59%+/-5% at T-0 to 57%+/-6% at T-1 and 56%+/-5% at T-12. The PER of the LV fell from 3.03+/-0.40 end-diastolic volume per second (EDV/s) at T-0 to 2.79+/-0.47 at T-1 and 2.78+/-0.43 at T-12. The PFR of the LV dropped from 2.99+/-0.43 EDV/s at T-0 to 2.62+/-0.44 at T-1 and 2.56+/-0.42 at T-12. For the normalised ratios, no differences were observed. Significant differences were found for EF, PER and PFR between T-0 and T-1, and between T-0 and T-12, but no difference was found between T-1 and T-12. This report shows simultaneous impairment of the systolic and diastolic LV radionuclide parameters at 1 and 12 months after anthracycline therapy without alteration in the RV function.