1. Left ventricular dysfunction in patients receiving cardiotoxic cancer therapies are clinicians responding optimally?
- Author
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Yoon, Geoffrey J., Telli, Melinda L., Kao, David P., Matsuda, Kelly Y., Carlson, Robert W., and Witteles, Ronald M.
- Subjects
Adult ,Male ,Heart Ventricles ,Adrenergic beta-Antagonists ,heart failure ,Angiotensin-Converting Enzyme Inhibitors ,Antineoplastic Agents ,chemotherapy ,Antibodies, Monoclonal, Humanized ,Article ,Angiotensin Receptor Antagonists ,Ventricular Dysfunction, Left ,Young Adult ,Risk Factors ,Neoplasms ,cancer ,Humans ,Anthracyclines ,Aged ,Retrospective Studies ,Ultrasonography ,left ventricular dysfunction ,Dose-Response Relationship, Drug ,Antibodies, Monoclonal ,Stroke Volume ,Middle Aged ,Trastuzumab ,Prognosis ,Female ,Follow-Up Studies - Abstract
ObjectivesThe purpose of this study was to examine treatment practices for cancer therapy-associated decreased left ventricular ejection fraction (LVEF) detected on echocardiography and whether management was consistent with American College of Cardiology/American Heart Association guidelines.BackgroundPatients treated with anthracyclines or trastuzumab are at risk of cardiotoxicity. Decreased LVEF represents a Class I indication for drug intervention according to American College of Cardiology/American Heart Association guidelines.MethodsPatients receiving anthracycline or trastuzumab at Stanford University from October 2005 to October 2007 and who had undergone echocardiography before and after receiving an anthracycline or trastuzumab were identified. Chart review examined chemotherapy regimens, cardiac risk factors, imaging results, concomitant medications, and cardiology consultations.ResultsEighty-eight patients received therapy with an anthracycline or trastuzumab and had a pre-treatment and follow-up echocardiogram. Ninety-two percent were treated with anthracyclines, 17% with trastuzumab after an anthracycline, and 8% with trastuzumab without previous treatment with anthracycline. Mean baseline LVEF was 60%, with 14% having a baseline
- Published
- 2009