Total 12-Lead QRS Voltage in Patients Having Orthotopic Heart Transplantation for Heart Failure Caused by Adriamycin-Induced Cardiomyopathy

Cardiology. 2018;141(3):172-175. doi: 10.1159/000492748. Epub 2019 Jan 16.

Abstract

Objective: Although several studies have described the effects of adriamycin on the heart, electrocardiographic total 12-lead QRS voltage (distance in millimeters from the peak of the R wave to the nadir of either the Q or S wave, whichever was deeper, with 10 mm [1 mV] being standard) both before and after orthotopic heart transplantation (OHT) has not been reported. This study describes the total 12-lead QRS voltage in 8 patients studied at Baylor University Medical Center at Dallas, from 1994 to June 2018, who underwent OHT for severe heart failure caused by anthracycline-induced cardiomyopathy.

Method: Prior to OHT, the total 12-lead non-paced QRS voltages ranged from 86 to 189 mm (mean 125 ± 56) and for paced QRS voltages from 82 to 113 mm (mean 97 ± 15). The total 12-lead QRS voltages post-OHT ranged from 100 to 190 mm (mean 130 ± 30). Total 12-lead QRS voltages were lower in patients with a pacemaker than without.

Results/conclusion: These low voltages are like those found in patients with carcinoid syndrome, severe cardiac adiposity, cardiac amyloidosis, and cardiac sarcoidosis.

Keywords: Adriamycin cardiomyopathy; Cardiotoxicity; Orthotopic heart transplantation.

MeSH terms

  • Adult
  • Cardiomyopathies / chemically induced*
  • Cardiomyopathies / physiopathology
  • Cardiotoxicity
  • Child
  • Doxorubicin / adverse effects*
  • Electrocardiography*
  • Female
  • Heart Failure / etiology
  • Heart Failure / surgery*
  • Heart Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy

Substances

  • Doxorubicin