ABSTRACT
Echocardiography was used in the study of 40 patients with stage IIA-IVB lymphogranulomatosis. In 2-6 years before the study all patients had been treated with combination radio- (36-44 Gy) and chemotherapy. Echocardiography revealed endomyocardial fibrosis and signs of cardiac remodeling (reduced left ventricular dimensions and volumes, decreased myocardial mass and impaired diastolic function). The patients were divided into 2 groups. Patients of group 1 were given enalapril (5-10 mg/day), of group 2 - potassium and magnesium aspartate and inosine. In 2 months 68% of patients in group 1 demonstrated improvement of structural and functional state of the heart, no such changes occurred in group 2.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Enalapril/therapeutic use , Endomyocardial Fibrosis/drug therapy , Endomyocardial Fibrosis/etiology , Hodgkin Disease/radiotherapy , Radiotherapy/adverse effects , Adolescent , Adult , Endomyocardial Fibrosis/chemically induced , Female , Humans , Male , Middle AgedABSTRACT
AIM: The study of clinical and echocardiographic status of the heart in patients with lymphogranulomatosis (LGM) late after chemoradiotherapy. MATERIAL AND METHODS: 44 patients with IIA-IV stage of LGM exposed to irradiation of lymph nodes and polychemotherapy according to the schemes ACOP, ABVD, COPP, CHOP, CVPP were examined. Echocardiography was carried out on the unit Sigma-44 and Toshiba. RESULTS: Some changes in the heart by type of myocardiodystrophy or endomyocardial fibrosis were found. The latter are characterized by diminution of the left and (or) right ventricles due to apex obliteration, hardening and thickening of the endocardium and subvalvular structures, diastolic dysfunction and pulmonary hypertension. The main and additional signs are distinguished. The reasons of endomyocardial fibrosis are discussed: severity of the disease, frequent exacerbations and, consequently, higher doses of specific chemoradiotherapy. CONCLUSION: It is necessary to employ sparing policy in planning radiotherapy after high loading antracycline antibiotics.
Subject(s)
Antineoplastic Agents/therapeutic use , Heart Ventricles/physiopathology , Hodgkin Disease/physiopathology , Ventricular Function , Adolescent , Adult , Echocardiography, Doppler , Female , Follow-Up Studies , Heart Ventricles/diagnostic imaging , Heart Ventricles/drug effects , Heart Ventricles/radiation effects , Hodgkin Disease/diagnostic imaging , Hodgkin Disease/drug therapy , Hodgkin Disease/radiotherapy , Humans , Male , Middle Aged , Prognosis , Radiotherapy, Adjuvant , Time Factors , Ventricular Function/drug effects , Ventricular Function/radiation effects , Ventricular Remodeling/drug effects , Ventricular Remodeling/radiation effectsABSTRACT
AIM: Investigation of the condition of the liver, gastrointestinal tract, heart in patients at the stage of clinicohematological remission after treatment for hemoblastosis (acute leukemia, Hodgkin's disease, non-Hodgkin's lymphoma). RESULTS: Marked functional-morphological changes were found: endomyocardial fibrosis, cardiopathy, pulmonary hypertension, chronic atrophic gastritis, colon lesions, dysbacteriosis, viral or drug-induced hepatitis. CONCLUSION: The above affections have developed because of the treatment: chemotherapy, radiotherapy, hemotransfusions, antibacterial drugs. They deteriorate life quality and require a special system of rehabilitation measures.
