Key result
Doxorubicin is linked to ~4-fold more abnormal wall motion in RV versus LV segments.
Why the study?
Does doxorubicin chemotherapy cause more wall motion abnormalities in the right ventricle compared to the left ventricle in patients with malignancies?
Observational (n=52)
Does doxorubicin chemotherapy cause more wall motion abnormalities in the right ventricle compared to the left ventricle in patients with malignancies?
Absolute Event Rate: 19.9% vs 4.5%
p-value: p=<0.001
Doxorubicin chemotherapy is associated with a significantly higher incidence of wall motion abnormalities in the right ventricle, particularly the septum, compared to the left ventricle.
May warrant RV-inclusive surveillance in doxorubicin recipients; hypothesis-generating for differential ventricular cardiotoxicity.
Doxorubicin is a cytotoxic agent used in the treatment of patients with various malignancies. Its clinical value is limited by a dose-related cardiotoxicity. Wall motion was analyzed in 52 patients during different stages of treatment. Eleven patients were studied once, and in 41 patients serial radionuclide ventriculography was performed from 2 to 5 times. Abnormal wall motion was found in 96 out of 1,062 segments (9.0%), of which 33 out of 735 (4.5%) were in the left ventricle (LV) and 65 out of 327 (19.9%) were in the right ventricle (RV). The number of abnormalities in the RV was significantly higher than in the LV (P less than 0.001). Regional analysis of LV and RV in 109 40 degrees LAO studies and in 102 75 degrees LAO studies showed abnormal wall motion in the following segments: LV--posterobasal 6 (5.9%), inferior 2 (2.0%), anterior 5 (4.9%), anteroseptal 11 (10.1%), apical 5 (4.6%), posterolateral 4 (3.7%); RV--septal 44 (40.4%), apex 15 (13.8%), and the free wall 6 (5.5%). The left ventricular ejection fraction decreased from 74% median (M) in baseline studies to 54% (M) in the highest dose group (greater than 650 mg/m2). The present data show an increased number of wall motion abnormalities in the RV compared with the LV, particularly in the RV septum (P less than 0.001).
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Barendswaard et al. (1991) conducted an observational in Malignancies requiring chemotherapy (n=52). Doxorubicin vs. Left ventricle segments (internal comparison) was evaluated on Abnormal wall motion in ventricular segments (p=<0.001). Doxorubicin treatment was associated with significantly more abnormal wall motion in right ventricular segments (19.9%) compared to left ventricular segments (4.5%) (P<0.001).
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