Table 3.
Patient | First LVEF (%) | Last LVEF (%) | Lowest LVEF (%) | Chemotherapy administered before lower LVEF or CVE onset | CVE manifestation | Details on cardiotoxicity | Onset of CVE | Cardiac treatment |
---|---|---|---|---|---|---|---|---|
Patient 1 | 73 | 50 | 48 | MTX+VCR, VP16, HD-Cyclophosphamide, Carboplatin | Asymptomatic LV dysfunction | BNP elevation, abnormalities of ventricular repolarization at EKG hypokinesia of the interventricular septum, | Acute | Diuretics, β-blockers, inotropes |
Patient 2 | 70 | 62 | 48 | MTX+VCR, VP16 | Symptomatic LV disfunction | Rest dyspnea, tachycardia, BNP elevation, prolonged QTc interval at EKG, hypokinesia of the interventricular septum, mild pericardial effusion, mild mitral and tricuspid valve regurgitation | Acute | Diuretics, β-blockers, ACE inhibitors |
Patient 3 | 73 | 62 | 45 | MTX+VCR, VP16, HD-Cyclophosphamide, Carboplatin, Thiotepa | Asymptomatic LV dysfunction | BNP elevation, reduced QRS voltages in all EKG leads, increased left ventricular volume, mild mitral and tricuspid valve regurgitation | Chronic | Diuretics, β-blockers, inotropes |
Patient 4 | 67 | 68 | 66 | MTX+VCR, VP16 | Arterial hypertension | None | Acute | ACE inhibitors |
Patient 5 | Not Available | 62 | 62 | MTX+VCR, VP16, HD-Cyclophosphamide, Carboplatin, Thiotepa | Ectopic atrial tachycardia | Prolonged QTc interval at EKG | Chronic | β-blockers |
Patient 6 | 70 | 75 | 58 | MTX+VCR, VP16, Cyclophosphamide, Carboplatin, Thiotepa, Temozolomide | Hypokinesia of the interventricular septum with dyspnea and BNP elevation | Arterial hypertension, acute prerenal renal failure, mild pericardial effusion, mild aortic, mitral and tricuspid valves regurgitation | Chronic | Diuretics, ACE inhibitors |
List of abbreviations: ACE, angiotensin converting enzyme; BNP, brain natriuretic peptide; CVE, cardiovascular events; EKG, electrocardiogram; HD, high dose; LV, left ventricular; LVEF, left ventricular ejection fraction; MTX, methotrexate; VCR, vincristine; VP16, etoposide.