Address for correspondence and reprint requests: Paolo Pattoneri, M.D., Department of Internal Medicine, Nephrology and Health Sciences, University of Parma, Via Gramsci 1, 43100 Parma, Italy. Fax: +390-521033185; E-mail: [email protected]

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Abstract

Aim: Tissue Doppler echocardiography was investigated for its applicability in detecting subtle myocardial involvement in multiple sclerosis patients receiving a low dose of mitoxantrone. Methods and Results: Twenty Caucasian patients with multiple sclerosis (mean age 43.9±9.3 years, 12 males and 8 females) treated with mitoxantrone (mean cumulative dose 35.4±21.6 mg/m²), were compared to 20 healthy subjects (mean age 45.4±15.3 years, 11 males and 9 females) matched for age and gender. All subjects underwent conventional and Tissue Doppler echocardiography. Patients with heart failure, life-threatening arrhythmias, and other prominent manifestations of heart disease were excluded. No differences were observed in blood pressure, heart rate, and conventional systolic and diastolic echocardiographic parameters. At Tissue Doppler echocardiography, patients with multiple sclerosis showed differences of the systolic mechanic expressed by a significant lower S-wave peak velocity at the lateral site of mitral annulus (11.4±2.5 cm/sec vs. 15.0±4.1 cm/sec, P < 0.02). Such S-wave peak velocity significantly correlated with a cumulative dose of mitoxantrone (r =−0.37, P < 0.05). Conclusion: Tissue Doppler echocardiography suggests an early involvement of the systolic myocardial function at the low dose of mitoxantrone. Therefore, Tissue Doppler echocardiography may be used as a noninvasive method for monitoring subclinical cardiotoxicity in multiple sclerosis patients receiving mitoxantrone.

References

1 Edan G, Miller D, Clanet M, et al: Therapeutic effect of mitoxantrone combined with methylprednisolone in multiple sclerosis: A randomized multicentre study of active disease using MRI and clinical criteria. J Neurol Neurosurg Psychiatry 1997; 62: 112–118.
10.1136/jnnp.62.2.112
CAS PubMed Web of Science® Google Scholar
2 Hartung HP, Gonsette R, Konig N, et al: Mitoxantrone in progressive multiple sclerosis: A placebo-controlled, duble-blind, randomised, multicentre trial. Lancet 2002; 360: 2018–2025.
10.1016/S0140-6736(02)12023-X
PubMed Web of Science® Google Scholar
3 Praga C, Beretta G, Vigo PL, et al: Adriamycin cardiotoxicity: A survey of 1273 patients. Cancer Treat Rep 1979; 63: 827–834.
CAS PubMed Web of Science® Google Scholar
4 Edan G, Brochet B, Clanet M, et al: Safety profile of mitoxantrone in a cohort of 800 multiple sclerosis patients. Mult Scler 2001; 7: S14.
Google Scholar
5 Mauch E, Kornhuber HH, Krapf H, et al: Treatment of multiple sclerosis with mitoxantrone. Eur Arch Psychiatry Clin Neurosci 1992; 242: 96–102.
10.1007/BF02191555
CAS PubMed Web of Science® Google Scholar
6 Hartung HP, Gonsette R, Morrissey SP, et al: Mitoxantrone. In RA Rudick, DE Goodkin (eds): Multiple Sclerosis Therapeutics. London : Martin Dunitz, 1999, pp. 335–348.
Google Scholar
7 De Castro S, Cartoni D, Millefiorini E, et al: Noninvasive assessment of mitoxantrone cardiotoxicity in relapsing remitting multiple sclerosis. J Clin Pharmacol 1995; 35: 627–632.
10.1002/j.1552-4604.1995.tb05021.x
CAS PubMed Web of Science® Google Scholar
8 Strotmann JM, Spindler M, Weilbach FX, et al: Myocardial function in patients with multiple sclerosis treated with low-dose of mitoxantrone. Am J Cardiol 2002; 89: 1222–1225.
10.1016/S0002-9149(02)02312-3
CAS PubMed Web of Science® Google Scholar
9 Sohn DW, Chai IH, Lee DJ, et al: Assessment of mitral annulus velocity by doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997; 30: 474–480.
10.1016/S0735-1097(97)88335-0
CAS PubMed Web of Science® Google Scholar
10 Oki T, Tabata T, Yamada H, et al: Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. Am J Cardiol 1997; 79: 921–928.
10.1016/S0002-9149(97)00015-5
PubMed Web of Science® Google Scholar
11 Nagueh SF, Middleton KJ, Kopelen HA, et al: Doppler tissue imaging: A noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 1997; 30: 1527–1533.
10.1016/S0735-1097(97)00344-6
CAS PubMed Web of Science® Google Scholar
12 Gulati VK, Katz WE, Follansbee WP, et al: Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Am J Cardiol 1996; 77: 979–984.
10.1016/S0002-9149(96)00033-1
CAS PubMed Web of Science® Google Scholar
13 Galiuto L, Ignone G, DeMaria AN: Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol 1998; 81: 609–614.
10.1016/S0002-9149(97)00990-9
CAS PubMed Web of Science® Google Scholar
14 Schiller NB, Shah PM, Crawford M, et al: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358–368.
10.1046/j.1540-8175.2003.03020.x
CAS PubMed Web of Science® Google Scholar
15 Devereux RB, Reichek N: Echocardiographic determination of left ventricular mass in man: Anatomic validation of the method. Circulation 1977; 55: 613–618.
10.1161/01.CIR.55.4.613
CAS PubMed Web of Science® Google Scholar
16 Pattoneri P, Pelà G, Sozzi F, et al: Impact of myocardial geometry on left ventricular performance in healthy black and white young adults. Echocardiography 2008; 25: 13–19.
10.1111/j.1540-8175.2007.00556.x
CAS PubMed Web of Science® Google Scholar
17 Sohn DW, Chung WY, Chai IH, et al: Mitral annulus velocity in the noninvasive estimation of left ventricular peak dp/dt. Am J Cardiol 2001; 87: 933–6.
10.1016/S0002-9149(00)01546-0
CAS PubMed Web of Science® Google Scholar
18 Neilan TG, Jassal DS, Perez-Sanz TM, et al: Tissue Doppler imaging predicts left ventricular dysfunction and mortality in a murine model of cardiac injury. Eur Heart J 2006; 27: 1868–1875.
10.1093/eurheartj/ehl013
PubMed Web of Science® Google Scholar
19 Noseworthy JH, Gold R, Hartung HP: Treatment of multiple sclerosis: Recent trials and future perspectives. Curr Opin Neurol 1999; 12: 179–193.
10.1097/00019052-199906000-00007
Web of Science® Google Scholar
20 Millefiorini E, Gasperini C, Pozzilli C, et al: Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome. J Neurol 1997; 244: 153–159.
10.1007/s004150050066
CAS PubMed Web of Science® Google Scholar
21 Aviles A, Arevila N, Diaz Maqueo JC, et al: Late cardiac toxicity of doxorubicin, epirubicin, and mitoxantrone therapy for Hodgkin's disease in adults. Leuk Lymphoma 1993; 11: 275–279.
10.3109/10428199309087004
CAS PubMed Web of Science® Google Scholar
22 Ganz WI, Sridhar KS, Ganz SS, et al: Review of tests for monitoring doxorubicin-induced cardiomyopathy. Oncology 1996; 53: 461–470.
10.1159/000227621
PubMed Web of Science® Google Scholar
23 Prestor VV, Rakovec P, Kozelj M, et al: Late cardiac damage of anthracycline therapy for acute lymphoblastic leukemia in childhood. Pediatr Hematol Oncol 2000; 17: 527–540.
10.1080/08880010050122799
CAS PubMed Web of Science® Google Scholar
24 Suzuki J, Yanagisawa A, Shigeyama T, et al: Early detection of anthracycline-induced cardiotoxicity by radionuclide angiography. Angiology 1999; 50: 37–45.
10.1177/000331979905000105
CAS PubMed Web of Science® Google Scholar
25 Schmitt K, Tulzer G, Merl M, et al: Early detection of doxorubicin and daunorubicin cardiotoxicity by echocardiography: Diastolic versus systolic parameters. Eur J Pediatr 1995; 154: 201–204.
10.1007/BF01954271
CAS PubMed Web of Science® Google Scholar
26 Pattoneri P, Pelà G, Montanari E, et al: Evaluation of the myocardial performance index for early detection of mitoxantrone-induced cardiotoxicity in patients with multiple sclerosis. Eur J Echocardiogr 2007; 8: 144–150.
10.1016/j.euje.2006.02.009
PubMed Web of Science® Google Scholar
27 Pelà G, Bruschi G, Cavatorta A, et al: Doppler tissue echocardiography: Myocardial wall motion velocities in essential hypertension. Eur J Echo 2001; 2: 108–117.
10.1053/euje.2000.0057
CAS PubMed Google Scholar
28 Pelà G, Tirabassi G, Pattoneri P, et al: Cardiac involvement in the Churg-Strauss syndrome. Am J Cardiol 2006; 97: 1519–1524.
10.1016/j.amjcard.2005.11.088
PubMed Web of Science® Google Scholar

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Volume26, Issue4

April 2009

Pages 397-402

Assessment of Mitoxantrone-Induced Cardiotoxicity in Patients with Multiple Sclerosis: A Tissue Doppler Echocardiographic Analysis

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Assessment of Mitoxantrone-Induced Cardiotoxicity in Patients with Multiple Sclerosis: A Tissue Doppler Echocardiographic Analysis

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