Protective Effect of Carvedilol on Adriamycin-Induced Left Ventricular Dysfunction in Children With Acute Lymphoblastic Leukemia
Journal of Cardiac Failure, 08/10/2012  Clinical Article

El–Shitany NA et al. – The results suggested a protective role of carvedilol against Adriamycin (ADR)–induced cardiotoxicity.

• 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.