The utility of intraventricular pressure gradient for early detection of chemotherapy-induced subclinical cardiac dysfunction in dogs

Katsuhiro Matsuura, Kenjirou Shiraishi, Ahmed S. Mandour, Kotomi Sato, Kazumi Shimada, Seijirow Goya, Tomohiko Yoshida, Pitipat Kitpipatkun, Lina Hamabe, Akiko Uemura, Zeki Yilmaz, Mayumi Ifuku, Takeshi Iso, Ken Takahashi, Ryou Tanaka

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9 Citations (Scopus)


Early detection of doxorubicin (DXR)-induced cardiomyopathy (DXR-ICM) is crucial to improve cancer patient outcomes and survival. In recent years, the intraventricular pressure gradient (IVPG) has been a breakthrough as a sensitive index to assess cardiac function. This study aimed to evaluate the usefulness of IVPG for the early detection of chemotherapy-related cardiac dysfunc-tion. For this purpose, six dogs underwent conventional, speckle tracking, and color M-mode echo-cardiography concomitantly with pressure-and-volume analysis by conductance catheter. The cardiac function measurements were assessed before DXR administration (baseline, Pre), at the end of treatment protocol (Post), and at 1.5 years follow-up (Post2). The result showed a significant reduc-tion in the left ventricular end-systolic pressure-volume (Emax: 4.4 ± 0.7, 6.1 ± 1.6 vs. 8.4 ± 0.8 mmHg/mL), total-IVPG (0.59 ± 0.12, 0.62 ± 0.15 vs. 0.86 ± 0.12 mmHg), and mid-IVPG (0.28 ± 0.12, 0.31 ± 0.11 vs. 0.48 ± 0.08 mmHg), respectively in Post2 and Post compared with the baseline (p < 0.05). Mid-to-apical IVPG was also reduced in Post2 compared with the baseline (0.29 ± 0.13 vs. 0.51 ± 0.11). Meanwhile, the fraction shortening, ejection fraction, and longitudinal strain revealed no change between groups. Total and mid-IVPG were significantly correlated with Emax (R = 0.49; p < 0.05, both) but only mid-IVPG was a predictor for Emax (R2 = 0.238, p = 0.040). In conclusion, this study revealed that impairment of contractility was the initial changes observed with DXR-ICM in dogs and only IVPG could noninvasively detect subclinical alterations in cardiac function. Color M-mode echocardiography-derived IVPG could be a potential marker for the early detection of doxo-rubicin cardiomyopathy.

Original languageEnglish
Article number1122
Issue number4
Publication statusPublished - Apr 2021
Externally publishedYes


  • Cardiomyopathy
  • Dogs
  • Doxorubicin
  • Echocardiography
  • Heart failure
  • Intraventricular pressure gradient
  • Pressure-volume


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