TY - JOUR ID - TI - Assessment of anthracycline‑induced long‑term cardiotoxicity in patients with hematological malignancies AU - Dr. Tareq Abdullah Saleh PY - 2019 VL - 8 IS - 2 SP - 63 EP - 68 JO - Iraq Joural of Hematology المجلة العراقية لامراض الدم SN - 20728069 25432702 AB - BACKGROUND: Anthracyclines are antibiotic antineoplastic drugs used in the treatment of varioushematological and solid malignancies. They are well‑known for their cardiotoxic side effects which arerelated to their cumulative dosages. Many investigations are used to detect such cardiotoxicity, thegold standard of which is the endomyocardial biopsy that has a limited use because it is an invasiveprocedure. The aims of this study were to explore the cardiotoxicity induced by anthracyclines inpatients with hematological malignancies by using electrocardiography (ECG) and echocardiographyand to determine relationship between the detected changes in ECG and echocardiography, withsome demographic and clinical variables.PATIENTS AND METHODS: A cross‑sectional study of fifty patients was recruited at Al‑ImameinAl‑Kadhemein Medical City from March 2014 to January 2015. ECG and echocardiography were doneto the patients to study several parameters such as ejection fraction (EF), diastolic dysfunction, QRSvoltage, QRS duration, and corrected QT (QTc) both at baseline and reassessment. Reassessmentwas done after completing induction for leukemia patients and at mid‑term reassessment forlymphoma patients.RESULTS: ECG showed reduction in QRS voltage, increase in QRS duration, and increase inQTc, all of which showed statistical significance and may reflect the effect on the depolarizationand repolarization on the myocardium. The echo study showed the development of systolic leftventricular (LV) dysfunction (EF <55%) in 12% of patients and a statistically significant reductionin the mean of EF of the study group. It also showed statistically significant development of newdiastolic dysfunction. Statistically significant association between reduction of QRS voltage (>30%from baseline) with the development of LV dysfunction was also found.CONCLUSIONS: Significant changes in QRS voltage, QRS duration, QTc, as well as the occurrenceof LV systolic dysfunction and diastolic dysfunction were noted. The mean cumulative dose at whichLV systolic dysfunction occurred was about 250 mg/m2.

ER -