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Anthracycline-Treated Patients Have Lifelong Heart Decline

Cardiac function progressively declines in patients with malignant bone tumors in childhood

THURSDAY, July 20 (HealthDay News) -- Patients who had malignant bone tumors in childhood and were treated with anthracyclines require life-long cardiac monitoring, according to a prospective study published online July 20 in the Annals of Oncology.

C.A.J. Brouwer, M.D., of the University of Groningen in the Netherlands, and colleagues followed 22 patients treated with moderate or high doses of doxorubicin for osteogenic sarcomas or malignant fibrous histiocytomas. The median follow-up time was 22 years, and the average age at follow-up was about 39 years. The cumulative dose of doxorubicin was 360 mg/m2. Researchers assessed cardiac function with echocardiography and 24-hour electrocardiogram.

The investigators found that 27 percent of participants had systolic dysfunction and 45 percent had diastolic dysfunction. At earlier follow-up, less than one in 10 had systolic dysfunction and less than a fifth had diastolic dysfunction, the researchers report. When they compared heart rate variability with earlier assessments taken at nine and 14 years after treatments, they found additional deterioration.

"After treatment with anthracyclines there is an ongoing deterioration of cardiac function and no extinction is anticipated," the study authors conclude. "Therefore, anthracycline-treated cancer survivors are considered for life-long cardiac surveillance."

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