Anthracyclines are among the most widely used and effective
antineoplastic agents. A growing number of patients treated with
anthracyclines may have the potential for substantial morbidity and
mortality owing to anthracycline cardiotoxicity. Patients younger than 75
years and without heart failure or pulmonary disease are more likely to
receive chemotherapy. The main manifestations of acute cardiotoxicity
are cardiac rhythm disturbances and the pericarditis/myocarditis
syndrome, while early (several days to months following therapy) and
late (years to decades after treatment) cardiotoxicity is mainly
characterized by deterioration of myocardial function. Subclinical
cardiomyopathy is quite more prevalent than symptomatic heart failure.
Various predisposing factors have been proposed, such as total dose of
anthracyclines > 550mg/m2, high rate of administration, previous chest
irradiation, young or advanced age, female sex, and coexistent heart
disease and/or arterial hypertension. The early detection of
cardiotoxicity may lead to the modification of chemotherapeutic
regimen, and to the timely administration of medications for the
treatment of cardiomyopathy, such as beta-blockers and ACE
inhibitors. Echocardiography during low dose dobutamine infusion
(10 mg/kg/min) has the potential to reveal abnormalities of myocardial
contractile reserve, while Doppler echocardiography of the mitral valve
inflow during diastole has been used for the assessment of left ventricular
(LV) diastolic function. This study examines whether the combination of
repetitive dobutamine stress echocardiography (DSE) with evaluation of
Doppler mitral inflow pattern can be used to predict the development of
anthracycline cardiomyopathy