PEDIATRICS Vol. 68 No. 1 July 1981, pp. 67-72
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Recovery of Left Ventricular Function Following Discontinuation of Anthracycline Chemotherapy in Children

Alan B. Lewis MD1, Vonda L. Crouse MD1, William Evans MD1, Masato Takahashi MD1, and Stuart E. Siegel MD1

1 Division of Cardiology and Hematology-Oncology, Childrens Hospital of Los Angeles, and Department of Pediatrics, University of Southern California School of Medicine, Los Angeles

Echocardiographic evaluation of left ventricular (LV) performance was performed in 41 children during and following anthracycline chemotherapy. Prior to treatment LV function was normal in all patients; LV shortening fraction was 35.2 ± 0.7% and percent of predicted velocity of circumferential fiber shortening was 110 ± 2%. However, the indices measured concurrent with the final anthracycline dose (mean = 308 ± 16 mg/sq m) demonstrated a significant decline in LV function. The LV shortening fraction had decreased to 29.5 ± 0.8% and percent of predicted velocity of circumferential fiber shortening decreased to 94 ± 4% (P < .01). Four of the eight patients with evidence of significant LV dysfunction had received thoracic or upper abdominal irradiation. Following cessation of anthracycline therapy, LV function improved within one to six months and had returned to normal in all but two patients, both of whom received irradiation. Echocardiography is useful for the identification of anthracycline-induced LV dysfunction. With discontinuation of further anthracycline administration the functional decline in LV performance appears to be reversible.

Submitted on June 9, 1980
Accepted on September 3, 1980




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