Goorin A M, Borow K M, Goldman A, Williams R G, Henderson I C, Sallan S E, Cohen H, Jaffe N
Cancer. 1981 Jun 15;47(12):2810-6. doi: 10.1002/1097-0142(19810615)47:12<2810::aid-cncr2820471210>3.0.co;2-4.
The congestive heart failure (CHF) associated with Adriamycin cardiotoxicity is frequently fatal. To investigate the course of Adriamycin-induced congestive heart failure, all Adriamycin-treated children who developed congestive heart failure at the Children's Hospital Medical Center and Sidney Farber Cancer Institute were studied. Criteria for Adriamycin-induced congestive heart failure included clinical evidence of left ventricular (LV) failure and echocardiographic evidence of abnormal left ventricular function. Fifteen children fulfilled these criteria. Eleven patients received between 400 and 500 mg/m2 of Adriamycin; four patients received cumulative doses over 500 mg/m2. Twelve of 15 (80%) children survived their acute episode of congestive heart failure. At follow-up, three patients had normalized their echocardiographic parameters of left ventricular function, three had died of their malignancies with compensated cardiac function until death, and six were clinically asymptomatic despite persistence of abnormal LV function on echocardiogram. Only three patients died of Adriamycin cardiomyopathy. In children treated with aggressive medical therapy, congestive heart failure secondary to Adriamycin cardiotoxicity may be reversible in certain cases.
与阿霉素心脏毒性相关的充血性心力衰竭往往是致命的。为了研究阿霉素诱发的充血性心力衰竭的病程，我们对所有在儿童医院医学中心和西德尼·法伯癌症研究所接受阿霉素治疗并出现充血性心力衰竭的儿童进行了研究。阿霉素诱发的充血性心力衰竭的标准包括左心室（LV）衰竭的临床证据和左心室功能异常的超声心动图证据。15名儿童符合这些标准。11名患者接受了400至500mg/m²的阿霉素治疗；4名患者接受的累积剂量超过500mg/m²。15名儿童中有12名（80%）在充血性心力衰竭急性发作后存活下来。在随访中，3名患者左心室功能的超声心动图参数恢复正常，3名患者死于恶性肿瘤，直至死亡时心脏功能仍处于代偿状态，6名患者尽管超声心动图显示左心室功能持续异常，但临床上无症状。只有3名患者死于阿霉素心肌病。在接受积极药物治疗的儿童中，阿霉素心脏毒性继发的充血性心力衰竭在某些情况下可能是可逆的。
