November 26, 2002Journal of Clinical Oncology
Long-Term Enalapril Therapy for Left Ventricular Dysfunction in Doxorubicin-Treated Survivors of Childhood Cancer
Key result
Enalapril therapy produced transient LV improvements that deteriorated by 6-10 years, with 6/6 patients with baseline heart failure dying or requiring transplant versus 3/12 asymptomatic patients.
Why the study?
Does long-term enalapril therapy improve left ventricular structure and function in doxorubicin-treated survivors of childhood cancer?
Population
18 doxorubicin-treated survivors of childhood cancer with left ventricular dysfunction.
Design
Cohort
Follow-up
median 10 years
Authors
Discussion
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Implication
Caution against expecting sustained LV benefit from enalapril in doxorubicin survivors; leaves open need for durable therapies and randomized trials.
Study Design
Type
Cohort (n=18)
Structured PICO
Does long-term enalapril therapy improve left ventricular structure and function in doxorubicin-treated survivors of childhood cancer?
P
Population
18 doxorubicin-treated survivors of childhood cancer receiving enalapril therapy, followed for a median of 10 years.
E
Exposure
Enalapril therapy
O
Outcome
Long-term effects on left ventricular structure and function (LV dimension, afterload, fractional shortening, mass, wall thickness, contractility) and clinical outcomes (death or cardiac transplantation)surrogate
In doxorubicin-treated childhood cancer survivors, enalapril provides only transient improvement in left ventricular structure and function, with eventual deterioration and poor outcomes in those with baseline heart failure.
Cite This Study
Lipshultz et al. (2002) conducted a cohort in Left ventricular dysfunction in doxorubicin-treated survivors of childhood cancer (n=18). Enalapril was evaluated on Left ventricular structure and function (LV dimension, afterload, fractional shortening, mass, and wall thickness). Enalapril therapy produced transient LV improvements that deteriorated by 6-10 years, with 6/6 patients with baseline heart failure dying or requiring transplant versus 3/12 asymptomatic patients.