Protective effect of carvedilol on adriamycin-induced left ventricular dysfunction in children with acute lymphoblastic leukemia.

Abstract

BACKGROUND:

Adriamycin (ADR) is a potent chemotherapeutic agent widely used in the treatment of childhood acute lymphoblastic leukemia (ALL); its clinical use is limited owing to its marked cardiotoxicity. The present study investigated the possible protective role of carvedilol on ADR-induced left ventricular dysfunction in children with ALL.

METHODS AND RESULTS:

Fifty children with newly diagnosed ALL were included in this study. They were divided into 2 equal groups: 1) ADR; and 2) ADR + carvedilol. Patients were evaluated with conventional 2-dimensional echocardiographic examination (2D), pulsed tissue Doppler (PTD), and 2-dimensional longitudinal strain echocardiography (2DS) before and after therapy. Plasma lactic dehydrogenase (LDH), creatine phosphokinase (CPK), and troponin I levels were also determined before and after therapy. ADR treatment reduced left ventricular systolic dysfunction as assessed by a significant decrease in fractional shortening (FS) (2D) and global peak-systolic strain (GPSS; 2DS). In addition, ADR treatment significantly increased plasma troponin I and LDH. Pretreatment of ADR-treated patients with carvedilol resulted in a significant increase in FS (2D) and GPSS (2DS). Furthermore, carvedilol pretreatment inhibited ADR-induced increase in plasma troponin I and LDH.

CONCLUSIONS:

These results suggested a protective role of carvedilol against ADR-induced cardiotoxicity.

• Authors: Nagla A El-Shitany, Osama A Tolba, Mohamed R El-Shanshory, Eslam E El-Hawary
• Journal: Journal of cardiac failure (J Card Fail) Vol. 18 Issue 8 Pg. 607-13 (Aug 2012) ISSN: 1532-8414 [Electronic] United States
• PMID: 22858075 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antibiotics, Antineoplastic
• Carbazoles
• Propanolamines
• Vasodilator Agents
• Carvedilol
• Doxorubicin

Topics

• Antibiotics, Antineoplastic (adverse effects)
• Carbazoles (pharmacology, therapeutic use)
• Carvedilol
• Child
• Child Welfare
• Doxorubicin (adverse effects)
• Female
• Humans
• Male
• Pediatrics
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, pathology)
• Propanolamines (pharmacology, therapeutic use)
• Time Factors
• Ultrasonography
• Vasodilator Agents (pharmacology, therapeutic use)
• Ventricular Dysfunction, Left (chemically induced, diagnostic imaging, pathology)