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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combined chemohormonal therapy of metastatic prostate cancer has not been previously evaluated in patients failing primary hormones (estrogens and/or orchiectomy). The combination of Adriamycin and high-dose diethylstilbestrol diphosphate (Stilphostrol) was studied in 19 heavily pretreated patients, to document toxicity and patient acceptability. Major toxicity was myelosuppression, cardiac failure and venous thrombosis. Clinical improvement was noted in 10/16 (63%) of evaluable patients. Patients with pre-existing cardiac disease or venous thrombosis are not suitable for this therapy.
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PMID:Chemohormonal therapy of metastatic prostate cancer. A pilot study. 686 Oct 82

An 18-year-old man had had an osteogenic sarcoma of the distal tibia at age 16. Below-knee amputation was carried out and followed by adjuvant chemotherapy with Adriamycin, vincristine, methotrexate, Cytoxan, and melphalan. One month after termination of chemotherapy, he died suddenly while playing tennis. Documented ventricular fibrillation was unresponsive to cardiopulmonary resuscitation. Myocardial fibrosis ("cardiomyopathy") was the only significant anatomic finding at autopsy. The occurrence of sudden death without antecedent cardiac failure may have been related to strenuous physical activity in this patient who had received combined adjuvant chemotherapy.
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PMID:Sudden cardiac death following adriamycin therapy. 694 Jun 49

The aim of this study was to detect the cardiotoxicity of Adriamycin (ADM) by the evolution of the systolic time intervals (STI). The PEP/LVET ratio represents an easy and reproducible index of myocardial function. The more important this increase, the greater the risk of developing heart failure. A significant correlation exists between the variation of this ratio and the total administered dose, but the correlation coefficient is low. A heart failure may appear for doses of ADM under 500 mg/m2 but it is preceded by an increase of the index. In the absence of a significant modification, the generally admitted maximum dose of 550 mg/m2 may be exceeded. In case of a ratio increase in excess of 0.08 it will be necessary to balance the potential benefits of treatment with the hazards of cardiac failure. The PEP/LVET ratio allows proceeding with the cytostatic treatment in increased security by selecting the patients at high risk for cardiac failure.
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PMID:Adriamycin cardiotoxicity. Prognostic value of the systolic time intervals. 698 May 47

Adriamycin is a cytotoxic drug with a broader spectrum of activity against various cancers than older drugs. Therefore there are numerous indications for the application of adriamycin in monotherapy and polychemotherapy. Besides other side effects which are common to all cytotoxic drugs adriamycin induces heart failure when applied in doses of 500 mg/sqm body surface. Cardiotoxicity may be reduced by weekly application instead of 3 week intervals and by concommittant application of calcium antagonists (verapamil). It seems that the potential value of adriamycin in cancer chemotherapy is as yet not fully explored.
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PMID:[Status of adriamycin in cancer therapy]. 716 92

Serial electrocardiograms, phonocardiograms and echocardiograms were recorded in a prospective study of 45 closely-followed patients receiving chemotherapy with Adriamycin (doxorubicin hydrochloride, Adria Labs.). QRS voltage, systolic time intervals (STI), echocardiographic ejection fraction (EF) and rate of ventricular circumferential fiber shortening (Vcf) were compared as indicators of Adriamycin cardiotoxicity. Seven patients (16%) developed a decline in left ventricular function. Four of these seven patients (57%) developed symptoms and signs of congestive heart failure (CHF). The pre-ejection period/left ventricular ejection time (PEP/LVET) was earliest to change and was the least specific of the noninvasive parameters. The ejection fraction was the most specific parameter in predicting clinical cardiotoxicity. In every case of congestive heart failure, significant changes in ejection fraction, Vcf and PEP/LVET preceded the onset of symptoms, suggesting that measurement of the ejection fraction and systolic time intervals will allow early prediction and avoidance of heart failure. A fall in the ejection fraction of greater than or equal to 10% may represent sufficient grounds for discontinuing Adriamycin.
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PMID:Comparative analysis of noninvasive cardiac parameters in the detection and evaluation of adriamycin cardiotoxicity. 725 65

Sixty breast cancer patients with hormone-resistant metastatic disease who had progressed after chemotherapy with low-dose cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) or with L-phenylalanine mustard underwent treatment with a low-dose Adriamycin regimen,i.e., 20 mg/m2, intravenously on days 1 and 8 every 28 days. Two percent of patients had complete responses; 25%, partial responses; 38%, stabilization; and 35%, progression. The time to progression for the responders was similar to that of the stabilized patients, while the responders and stabilized patients survived significantly longer than did the progressors. Responses were seen in nodal, hepatic, dermal/subcutaneous, bone, pulmonary, and peritoneal metastases. The toxicity was mild: 18% of patients had leukocyte counts of less than 3,000/mm3; 10% had platelet counts of less than 90,000/mm3, 22% experience vomiting; and 33% had hair loss. No patient experienced local venous/subcutaneous toxicity or heart failure. Since this regimen of low-dose Adriamycin appears to be as effective as, but less toxic than, the secondary standard-dose of Adriamycin at 60--75 mg/m2 every three weeks, a randomized trial of low-dose Adriamycin vs. standard-dose Adriamycin should be conducted in metastatic breast cancer patients who have previously undergone chemotherapy.
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PMID:An effective low-dose adriamycin regimen as secondary chemotherapy for metastatic breast cancer patients. 739 18

The influence of increasing doses of doxorubicin on the heart was examined in 30 patients with solid tumors, M-mode echocardiography being used to evaluate left ventricular contractility. The function of the left ventricle remained normal in 26 subjects, whereas four patients had evidence of cardiotoxicity after cumulative doses of 220, 380, 420, and 450 mg/m2. Transient overt heart failure was noted in one subject only. Doxorubicin cardiotoxicity can be detected by M-mode echocardiography, a simple and non-invasive technique, prior to the appearance of overt congestive heart failure. Patients demonstrating left ventricular dysfunction are probably not candidates for receiving further therapy with anthracycline antibiotics. Limitation of M-mode echocardiography include a 28% incidence of inadequate studies in this group of patients, and a relative inaccuracy of the technique in evaluating patients with prior myocardial infarction.
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PMID:Early detection of doxorubicin cardiotoxicity by M-mode echocardiography. 747 16

Adriamycin (doxorubicin) is a broad spectrum anti-tumor antibiotic used to treat cancer patients. However, the potential usefulness of this drug is currently limited by the development of a dose-dependent cardiomyopathic process terminating in severe heart failure. Although several mechanisms have been suggested to explain the pathogenesis of adriamycin-induced cardiomyopathy, free-radical induced oxidative stress appears to play an important role. A concise description of adriamycin-induced cardiomyopathy is provided. Various combination therapies which have been attempted in the past to modulate the adriamycin-induced cardiomyopathy are also discussed. Recently, it has been discovered that probucol, a lipid lowering agent and potent antioxidant, provides complete protection against adriamycin-induced cardiomyopathy in rats without interfering with the anti-tumor properties of this antibiotic. Clinical trials employing adriamycin therapy in combination with probucol are needed to determine the applied value of these laboratory findings.
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PMID:Combination therapy with probucol prevents adriamycin-induced cardiomyopathy. 756 2

The cardiotoxic effects of Daunomycin (DM) ad Adriamycin (ADR), Anthracyclines (ATC), were studied mainly by echocardiography to evaluate their chronic cumulative cardiotoxicity and acute cardiotoxicity during consolidation therapy. Electrocardiographic findings were less sensitive and therefore less reliable for evaluation of the chronic cumulative cardiotoxicity and acute cardiotoxicity induced by ATCs during consolidation therapy. With echocardiography ESS/ESVI, the index of the left ventricular contraction, had the highest sensitivity among indices for cardiotoxicity. SF was useful for easy measurement and calculation of cardiotoxicity. Evaluation of the chronic cumulative cardiotoxicity of ATC drugs indicated that cumulative doses of 300 mg/m2 or more resulted in abnormally low ESS/ESVI levels suggesting cardiotoxicity in many cases, and doses of 500 mg/m2 or more caused abnormally low levels in all cases. Evaluation of acute cardiotoxicity showed that post-consolidation therapy ESS/ESVI levels were significantly lower than pre-consolidation therapy levels in the group treated with doses of 500 mg/m2 or more, but the condition was reversible except in those patients with heart failure. As for the relation between cumulative doses and cardiotoxicity, the indices studied showed no differences between DM and ADR. These results indicate that careful follow-up mainly by echocardiography is required after doses reaching 300 mg/m2 or more of ATC drugs.
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PMID:[Noninvasive evaluation of chronic cumulative and acute cardiotoxicity induced by anthracycline in children with acute leukemia. Assessment of mainly left ventricular contractile state by M mode echocardiography]. 804 95

Echocardiographic reports on 144 adults receiving anthracycline therapy and 18 controls were reviewed for the possible relationship between dosage and ejection fractions. The cardiotoxicity of each anthracycline drug was evaluated as follows: Pirarubicin = 0.8, Mitoxantrone = 3.4, Daunorubicin = 0.5, Aclarubicin = 0, and Epirubicin = 0.6 with Doxorubicin = 1 as a control. As a whole, the ejection fractions, which decreased subsequently compared with increasing amount of dosage, showed a remarkable decrease at the dosage level of 600 mg/m2. However, the ejection fractions differed among individual patients. It was predicted that heart failure would not develop when the ejection fractions exceeded 55%. It is desirable to stop anthracycline therapy when the ejection fractions drop to 55%.
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PMID:[Echocardiographic evaluation of cardiotoxicity induced by anthracycline therapy]. 908 92


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