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Effect of Enalapril on Preventing Anthracycline-Induced Cardiomyopathy
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Journal Article
Effect of Enalapril on Preventing Anthracycline-Induced Cardiomyopathy
2017
Overview
Anthracycline (ANT) is a topoisomerase-interacting agent that is used in most malignancy treatments. We investigated the efficacy of enalapril (angiotensin-converting enzyme inhibitor) in the prevention of ANT-induced cardiomyopathy. In this randomized, single-blind, and placebo-controlled study, 69 patients with a newly diagnosed malignancy for which ANT therapy was planned were randomly assigned to either a group receiving enalapril (
n
= 34) or placebo (
n
= 35). Echocardiography studies were performed before chemotherapy and at 6 months after randomization. Additionally, troponin I and creatinine kinase-MB (CK-MB) were measured 1 month after the initiation of chemotherapy. In the enalapril group, the mean left ventricular ejection fraction (LVEF) (
p
= 0.58) was the same at baseline and 6 months after randomization. Conversely, LVEF significantly decreased in the control group (
p
< 0.001). Additionally, LV end systolic volume and left atrial diameter were significantly increased compared with the baseline measures in the control group. According to the tissue Doppler study, the mitral annuli early diastolic (
e
′) and peak systolic (
s
′) velocities were significantly reduced, and the
E
(the peak early diastolic velocity)/
e
′ ratio was significantly increased in the control group. Furthermore, the TnI and CK-MB levels were significantly higher in the control group than in the enalapril group. Enalapril appears efficacious in preserving systolic and diastolic function in cancer patients treated with ANTs.
Publisher
Springer US,Springer,Springer Nature B.V
Subject
/ Angiotensin-Converting Enzyme Inhibitors - therapeutic use
/ Anthracyclines - adverse effects
/ Antibiotics, Antineoplastic - adverse effects
/ Biomedical and Life Sciences
/ Cancer
/ Cardiomyopathies - chemically induced
/ Cardiomyopathies - diagnostic imaging
/ Cardiomyopathies - physiopathology
/ Cardiomyopathies - prevention & control
/ Creatine Kinase, MB Form - blood
/ Enzymes
/ Female
/ Humans
/ Iran
/ Kinases
/ Male
/ Medicine
/ Myocardial Contraction - drug effects
/ Oncology
/ Stroke Volume - drug effects
/ Topoisomerase Inhibitors - adverse effects
/ Ventricular Dysfunction, Left - chemically induced
/ Ventricular Dysfunction, Left - diagnostic imaging
/ Ventricular Dysfunction, Left - physiopathology
