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Myocardial high-energy phosphate metabolism is altered after treatment with anthracycline in childhood

Published online by Cambridge University Press:  19 August 2008

Andrea B. Eidenschink ,
Gerrit Schröter ,
Stefan Müller-Weihrich  and
Heiko Stern
Andrea B. Eidenschink*
Affiliation:
Department of Pediatrics
Gerrit Schröter
Affiliation:
Department of Nuclear Medicine, Technical University of Municb
Stefan Müller-Weihrich
Affiliation:
Department of Pediatrics
Heiko Stern
Affiliation:
Department of Pediatric Cardiology, University of Hamburg Eppendorf, Germany
*
Andrea B Eidenschink, MD, Children's Hospital, Technical University of Munch, Kolner Platz 1, 80804 Munch, Germany, Tel +49 8930682286, Fax +49 89 30683811, E-mail: Andrea@Eidenschinks de
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Abstract

Objectives

We aimed to investigate whether changes in high-energy phosphate metabolism after treatment of children and young adults with anthracycline can be demonstrated non-invasively by 31P magnetic resonance spectroscopy.

Background

Abnormal myocardial energy metabolism has been suggested as a mechanism for anthracycline-induced cardiotoxicity. Deterioration in such has been shown in animal studies by resonance spectroscopy.

Methods

We studied 62 patients, with a mean age of 13.5 ±5 years,3.7±4.3 years after a cumulative anthracycline dose of 270±137 mg/m2. Normal echocardiographic findings had been elicited in 54 patients. The control group consisted of 28 healthy subjects aged 20±7 years. Resonance spectrums of the anterior left ventricular myocardium were obtained at 1.5 Tesla using an image-selected in vivo spectroscopy localization technique.

Results

The ratio of phosphocreatine to adenosine triphosphate after blood correction was 1.09±0.43 for the patients, and 1.36±0.36 (mean±SD)for controls (p = 0.005), with a significantly reducedmean ratio even in the subgroup of patients with normal echocardiographic results ( l.11 ± 0. 44 versus1.36±0.36, p=0.01). The ratio did not correlate with the cumulative dose of anthracycline. The ratio of phosphodiester to adenosine triphosphate was similar in patients and controls (0.90±0.56 versus 0.88±0.62).

Conclusions

In patients treated with anthracyclines in childhood, myocardial high-energy phosphate metabolism may be impaired even in the absence of cardiomyopathy. Our data support the concept that anthracycline-induced cardiotoxicity is not clearly dose dependent.

Keywords

Magnetic resonance spectroscopy, high-energy phosphatesmetabolismanthracyclinescardiotoxicity
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 6 , November 2000 , pp. 610 - 617
Copyright
Copyright © Cambridge University Press 2000

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