Carvedilol Administration Can Prevent Doxorubicin-Induced Cardiotoxicity: A Double-Blind Randomized Trial

被引:83
作者
Beheshti, Ahmad Tashakori [1 ]
Toroghi, Hesam Mostafavi [1 ]
Hosseini, Golkoo [3 ]
Zarifian, Ahmadreza [1 ]
Shandiz, Fatemeh Homaei [2 ]
Fazlinezhad, Afsoon [1 ]
机构
[1] Mashhad Univ Med Sci, Cardiovasc Res Ctr, Mashhad, Iran
[2] Mashhad Univ Med Sci, Canc Res Ctr, Mashhad, Iran
[3] Mashhad Univ Med Sci, Biochem & Nutr Res Ctr, Mashhad, Iran
关键词
Doxorubicin; Carvedilol; Doppler echocardiography; Cardiotoxins; ANTHRACYCLINE CHEMOTHERAPY; CARDIAC DYSFUNCTION; LONGITUDINAL STRAIN; EJECTION FRACTION; ECHOCARDIOGRAPHY;
D O I
10.1159/000442722
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The aim of this study is to evaluate the preventive effects of carvedilol on doxorubicin-induced cardiotoxicity. Methods: In this trial, 70 female patients with breast cancer who were candidates to receive doxorubicin were enrolled, from which 30 were selected randomly to receive carvedilol 6.25 mg daily during chemotherapy, with the rest receiving placebo as the control group. Both groups were evaluated 1 week before and 1 week after chemotherapy by measuring the left ventricular ejection fraction and strain/strain rate. Results: Data analysis showed that the case group presented no significant reduction in strain and strain-rate parameters after intervention, while there was a significant reduction in these parameters in the control group (all p values <0.001). Also, the mean differences of strain parameters in the case group were significantly less than in the control group in all evaluated heart walls (basal septal strain, p = 0.005, basal lateral strain, p = 0.001, basal inferior strain, p < 0.001, and basal anterior strain, p < 0.001); the same was true for the strain-rate parameters (the p values for basal septal, basal lateral, basal inferior and basal anterior strain rate were 0.037, 0.037, 0.002 and <0.001, respectively). Conclusion: This study shows that carvedilol can prevent doxorubicininduced cardiotoxicity. Whether this prophylaxis should be considered as the preferred method needs further investigation. (C) 2016 S. Karger AG, Basel
引用
收藏
页码:47 / 53
页数:7
相关论文
共 22 条
[1]   Epidemiology of Breast Cancer [J].
Ban, Kristen A. ;
Godellas, Constantine V. .
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA, 2014, 23 (03) :409-+
[2]  
Cardinale D, 2011, J CARDIOVASC ECHOGR, V21, P92
[3]   Doxorubicin-Induced Cardiotoxicity: From Bioenergetic Failure and Cell Death to Cardiomyopathy [J].
Carvalho, Filipa S. ;
Burgeiro, Ana ;
Garcia, Rita ;
Moreno, Antonio J. ;
Carvalho, Rui A. ;
Oliveira, Paulo J. .
MEDICINAL RESEARCH REVIEWS, 2014, 34 (01) :106-135
[4]   Low to Moderate Dose Anthracycline-Based Chemotherapy Is Associated With Early Noninvasive Imaging Evidence of Subclinical Cardiovascular Disease [J].
Drafts, Brandon C. ;
Twomley, Katie M. ;
D'Agostino, Ralph, Jr. ;
Lawrence, Julia ;
Avis, Nancy ;
Ellis, Leslie R. ;
Thohan, Vinay ;
Jordan, Jennifer ;
Melin, Susan A. ;
Torti, Frank M. ;
Little, William C. ;
Hamilton, Craig A. ;
Hundley, W. Gregory .
JACC-CARDIOVASCULAR IMAGING, 2013, 6 (08) :877-885
[5]   Effect of carvedilol on silent anthracycline-induced cardiotoxicity assessed by strain imaging: A prospective randomized controlled study with six-month follow-up [J].
Elitok, Ali ;
Oz, Fahrettin ;
Cizgici, Ahmet Y. ;
Kilic, Leyla ;
Ciftci, Rumeysa ;
Sen, Fatma ;
Bugra, Zehra ;
Mercanoglu, Fehmi ;
Oncul, Aytac ;
Oflaz, Huseyin .
CARDIOLOGY JOURNAL, 2014, 21 (05) :509-515
[6]   Comparison of preclinical cardiotoxic effects of different ErbB2 inhibitors [J].
Fedele, Carmine ;
Riccio, Gennaro ;
Coppola, Carmela ;
Barbieri, Antonio ;
Monti, Maria Gaia ;
Arra, Claudio ;
Tocchetti, Carlo G. ;
D'Alessio, Giuseppe ;
Maurea, Nicola ;
De Lorenzo, Claudia .
BREAST CANCER RESEARCH AND TREATMENT, 2012, 133 (02) :511-521
[7]   Anthracycline cardiotoxicity: From bench to bedside [J].
Gianni, Luca ;
Herman, Eugene H. ;
Lipshultz, Steven E. ;
Minotti, Giorgio ;
Sarvazyan, Narine ;
Sawyer, Douglas B. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (22) :3777-3784
[8]   Non-invasive imaging and monitoring cardiotoxicity of cancer therapeutic drugs [J].
Jiji, Ronny S. ;
Kramer, Christopher M. ;
Salerno, Michael .
JOURNAL OF NUCLEAR CARDIOLOGY, 2012, 19 (02) :377-388
[9]   Increase in doxorubicin cytotoxicity by carvedilol inhibition of P-glycoprotein activity [J].
Jonsson, O ;
Behnam-Motlagh, P ;
Persson, M ;
Henriksson, R ;
Grankvist, K .
BIOCHEMICAL PHARMACOLOGY, 1999, 58 (11) :1801-1806
[10]   Utility of 3-dimensional echocardiography, global longitudinal strain, and exercise stress echocardiography to detect cardiac dysfunction in breast cancer patients treated with doxorubicin-containing adjuvant therapy [J].
Khouri, Michel G. ;
Hornsby, Whitney E. ;
Risum, Niels ;
Velazquez, Eric J. ;
Thomas, Samantha ;
Lane, Amy ;
Scott, Jessica M. ;
Koelwyn, Graeme J. ;
Herndon, James E. ;
Mackey, John R. ;
Douglas, Pamela S. ;
Jones, Lee W. .
BREAST CANCER RESEARCH AND TREATMENT, 2014, 143 (03) :531-539