Assessment of late anthracycline-induced cardiotoxicity by I-123-mIBG cardiac scintigraphy in patients treated during childhood and adolescence

作者：dos Santos Marcelo Jose^*; da Rocha Euclides Timoteo; Verberne Hein J; da Silva Eduardo Tinois; Aragon Davi Casale; Soares Junior Jose

来源：Journal of Nuclear Cardiology, 2017, 24(1): 256-264.

DOI：10.1007/s12350-015-0309-y

• Cardiac sympathetic activity
• I-123-mIBG
• left ventricular function
• anthracycline

Purpose. The goal of this study was to evaluate late cardiotoxic effects of anthracyclines (ATC) by evaluating cardiac sympathetic activity in a cohort of asymptomatic patients previously treated with ATC for childhood cancers.
Methods. We studied 89 asymptomatic patients previously treated with ATC with a normal echocardiogram (49 men and 40 women) and a control group of 40 healthy individuals (26 men and 14 women). Both groups underwent planar myocardial I-123-meta-iodobenzylguanidine scintigraphy (I-123-mIBG). From these images, the early and late heart-to-mediastinum (H/M) ratio and washout rate (WR) were assessed.
Results. The mean survival at the time of the I-123-mIBG scintigraphy was 5.3 +/- 3.4 years. Patients treated with ATC had a lower but clinical normal left ventricular ejection fraction (LVEF) compared to controls (60.44 +/- 6.5 vs 64.1 +/- 6.0%, P < 0.01). Both the late H/M ratio and WR were not able to discriminate ATC treated patients from controls. The cumulative ATC dose was the only independent predictor of the LVEF, explaining approximately 12% of the variation in LVEF (P = 0.01).
Conclusions. Although the pathophysiology behind ATC cardiotoxicity is most likely multifactorial, myocardial sympathetic activity is not associated with a reduction in LVEF 5-years after completion of chemotherapy.

• 出版日期2017-2