Anthracyclines are widely used chemotherapeutic agents in the treatment of lymphomas known to induce cardiomyopathy in more than 20% of patients. There is increasing experimental evidence that cardiac endothelial cells regulate cardiac performance and that endothelin-1 (ET-1) is a central substance in this regulatory mechanism. Twenty (seven male, aged 20-68 years) patients with Hodgkin's or non-Hodgkin's lymphoma treated with anthracycline were followed-up for 1 year. At baseline, after cessation of anthracycline treatment and at 1 year, the plasma ET-1 level was measured by enzyme-linked immunosorbent assay and cardiac function was estimated by echocardiographic measurement of the ejection fraction, the E/A ratio and the deceleration time. The ET-1 level decreased significantly after therapy (5.47 ± 3.34 pg/mL versus 3.44 ± 0.69 pg/mL, P < 0.02), and remained significant at 1 year (3.43 ± 0.57 pg/mL, P < 0.008). The ejection fraction (57.80 ± 4.73% versus 48.05 ± 5.65%, P < 0.0001) and the E/A ratio (1.35 ± 0.40 versus 1.15 ± 0.40, P< 0.01) decreased, and the deceleration time (177.00 ± 44.96 ms versus 209.50 ± 66.25 ms, P < 0.04) increased significantly after therapy, showing that both systolic and diastolic left ventricular performance were deteriorated. Compared with the baseline, the same significant changes were found at 1 year (ejection fraction, 50.65 ± 8.87%, P < 0.0007; E/A ratio, 1.10 ± 0.34, P < 0.003; deceleration time, 223.25 ± 46.85 ms, P < 0.002). The decrease of the ET-1 concentration might be a result of anthracyclines' direct cytotoxic effect and the decreasing level of ET-1 may play a role in the ejection fraction reduction. The results of 1-year follow-up suggest that, although anthracycline toxicity occurs shortly after treatment, the undesirable effect remains.
|Journal||Journal of cardiovascular pharmacology|
|Issue number||SUPPL. 1|
|Publication status||Published - Nov 1 2004|
- Anthracycline therapy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine