Radionuclide cineangiography was used to evaluate 32 patients who sustained long-term remission of soft tissue sarcoma after adjuvant therapy with a cumulative doxorubicin dose from 480 to 550 mg/m2 body surface area. Left ventricular ejection fraction at rest was below normal (less than 45%) in 8 of 32 patients. The abnormal response of ejection fraction to exercise identified an additional 12 patients with diminished left ventricular functional reserve. Ejection fraction determined at rest or during exercise did not differ between patients studied an average of 5 mth (range, 1-9 mth) and those studied 30 mth (range, 21-43 mth) after completing doxorubicin treatment. Sequential studies in 13 patients, done 6-15 mth after initial post-doxorubicin evaluation also showed persistent depression of average ejection fraction at rest and with exercise, with the continued deterioration of left ventricular function in 6 patients. Left ventricular dysfunction, evident in over half of asymptomatic patients even long after 'acceptable' cumulative doses of doxorubicin, may persist for years.
ASJC Scopus subject areas
- Internal Medicine