Abstract Background: The aim of the present study was to investigate the detection of anthracycline cardiotoxicity by signal‐averaged electrocardiography (SAE) in children with cancer.
Methods: There were 29 patients with a cumulative
anthracycline (ATC) dose of 75−600 mg/m^2^.
None of them had congestive heart failure. Patients underwent SAE
just before (detection of chronic cardiotoxicity) and just after
(detection of acute cardiotoxicity) ATC therapy. Echocardiography
and Holter electrocardiography were performed
at the same time. The rates of abnormal SAE, echocardiography, and
electrocardiogram findings were calculated and compared for every
100 mg/m^2^ of ATC.
Results: The SAE showed a significantly higher
detection rate for acute cardiotoxicity was at a cumulative ATC
dose of less than 400 mg/m^2^ when compared
with other methods (P < 0.05).
The lowest dose at which acute cardiotoxicy was detected by SAE
was 117.3 mg/m^2^. The detection of chronic
cardiotoxicity by SAE was significantly higher at a cumulative ATC
dose of 100−400 mg/m^2^ when
compared with other methods (P < 0.05),
and the lowest value showing toxicity was 373.3 mg/m^2^.
The lowest ATC dose causing chronic cardiotoxicity was significantly
lower in patients less than 2‐years‐old (120.0 ± 28.3 mg/m^2^)
than in the other age groups (P < 0.05).
Conclusions: Acute and chronic ATC cardiotoxicity were detected by SAE at lower cumulative doses compared with other methods. The technique of SAE was a potentially useful method for detection of cardiotoxicity among those investigated and it provides useful information on subclinical cardiac dysfunction in patients receiving ATC therapy.