What is the clinical evidence from this study?

Population: Cancer (n=16). Intervention: Epirubicin vs. Baseline. Primary outcome: Strain rate (SR) peak.

What question did this study set out to answer?

To identify early preclinical myocardial dysfunction in cancer patients receiving epirubicin and correlate these functional changes with inflammatory and oxidative stress biomarkers.

September 1, 2007The OncologistOpen Access

Early Epirubicin-Induced Myocardial Dysfunction Revealed by Serial Tissue Doppler Echocardiography: Correlation with Inflammatory and Oxidative Stress Markers

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Key result

Epirubicin treatment at 200 mg/m2 caused early left ventricular systolic impairment, evidenced by a reduction in strain rate peak from 1.82/s at baseline to 1.45/s.

Why the study?

Does epirubicin-based chemotherapy induce early myocardial dysfunction detectable by tissue Doppler echocardiography and correlated with inflammatory and oxidative stress markers in cancer patients?

Population

16 patients with histologically confirmed tumors at different sites scheduled to be treated with an…

Comparison

Epirubicin-based chemotherapy regimen vs Baseline (pre-treatment)

Design

Cohort, nonrandomized, open

Authors

GMGiuseppe MercuroCardio-Oncology CDChristian Cadeddu DessalviUniversity of Cagliari APAlessandra PirasUniversity of Cagliari

Discussion

Member takes

Implication

Tissue Doppler imaging can detect early epirubicin-induced left ventricular systolic impairment at low cumulative doses, which correlates with increased reactive oxygen species.

Key Points

To identify early preclinical myocardial dysfunction in cancer patients receiving epirubicin and correlate these functional changes with inflammatory and oxidative stress biomarkers.
Enrolled 16 cancer patients (male-to-female ratio 3:13; mean age 56 ± 3 years, range 27–75) scheduled for epirubicin-based chemotherapy in a phase II open, nonrandomized trial.
Assessed left ventricular function at baseline and after cumulative epirubicin doses using conventional echocardiography and tissue Doppler imaging to evaluate strain and strain rate peak.
Measured circulating myocardial biomarkers (troponin I, BNP, myoglobin, CK-MB) alongside inflammatory and oxidative stress markers (IL-6, sIL-6R, ROS, and GPx).
Systolic left ventricular function deteriorated at 200 mg/m² epirubicin, evidenced by a reduced strain rate peak (1.45 ± 0.44/s vs 1.82 ± 0.57/s at baseline), while strain and ejection fraction remained unchanged.
Diastolic impairment emerged at 300 mg/m² epirubicin, showing decreased E/A velocity ratio (0.93 ± 0.24 vs 1.16 ± 0.31), Em wave velocity (7.51 ± 2.30 cm/s vs 8.86 ± 1.73 cm/s), and Em/Am ratio (0.83 ± 0.51 vs 1.09 ± 0.51).
Biomarkers IL-6 and ROS increased while GPx decreased at 200 mg/m² epirubicin, with ROS levels identified as the sole independent predictor of strain rate reduction in multiple regression analysis.

Structured PICO

Does epirubicin-based chemotherapy induce early myocardial dysfunction detectable by tissue Doppler echocardiography and correlated with inflammatory and oxidative stress markers in cancer patients?

Population

16 patients (mean age 56 years, 81% female) with histologically confirmed tumors scheduled for epirubicin-based chemotherapy.

Intervention

Epirubicin-based chemotherapy regimen (evaluated at cumulative doses of 200 mg/m2 and 300 mg/m2)

Comparator

Baseline (pre-treatment)

Outcome

Early preclinical changes in cardiac left ventricular (LV) function detected by conventional echocardiography and tissue Doppler imaging (TDI) with strain and strain rate, and correlation with biochemical markers of myocardial damage and inflammation/oxidative stresssurrogate

Main Result

Absolute Event Rate: 1.45% vs 1.82%

Tissue Doppler imaging can detect early epirubicin-induced left ventricular systolic impairment at low cumulative doses, which correlates with increased reactive oxygen species.

Limitations

Small sample size
Short period of follow-up
small sample size
short period of follow-up

Cite This Study

Mercuro et al. (2007) studied Cancer (n=16). Epirubicin vs. Baseline was evaluated on Strain rate (SR) peak. Epirubicin treatment at 200 mg/m2 caused early left ventricular systolic impairment, evidenced by a reduction in strain rate peak from 1.82/s at baseline to 1.45/s.

synapsesocial.com/papers/6a70775ffebe604dd70941a0 https://doi.org/10.1634/theoncologist.12-9-1124

Topics

HFrEF treatment Heart failure

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Implication

Tissue Doppler imaging can detect early epirubicin-induced left ventricular systolic impairment at low cumulative doses, which correlates with increased reactive oxygen species.

Early Epirubicin-Induced Myocardial Dysfunction Revealed by Serial Tissue Doppler Echocardiography: Correlation with Inflammatory and Oxidative Stress Markers

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Early Epirubicin-Induced Myocardial Dysfunction Revealed by Serial Tissue Doppler Echocardiography: Correlation with Inflammatory and Oxidative Stress Markers

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

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