Anthracycline therapy carries a significant risk of chronic cardiotoxicity and heart failure, necessitating long-term screening of left ventricular function.
Supports long-term LV monitoring in anthracycline recipients; confirms risks but leaves optimal frequency and modalities open for trials.
Anthracyclines are effective drugs used in a wide range of malignant diseases. The drugs have frequent, serious adverse effects including cardiotoxicity and resulting heart failure. Systematic reviews, meta-analyses and other relevant studies were identified using the Cochrane and the Medline databases. Chronic cardiotoxicity and heart failure may complicate anthracycline treatment often months to years after treatment has ended. Risk factors including diverse cardiac diseases increase the risk of chronic cardiotoxicity. Screening for impairment of left ventricular function with echocardiography or radionuclide ventriculography is recommended. Search for new sensitive methods has been prompted to predict development of heart failure at an early stage enabling to modify the chemotherapeutic regimen, to include cardiac protectants or to initiate treatment.
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Appel et al. (2007) studied this question.
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