{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:06:20Z","timestamp":1755219980283,"version":"3.43.0"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Adriamycin (doxorubicin hydrochloride) is a widely used chemotherapeutic agent for treating various malignancies. However, its most significant adverse effect is cardiac toxicity. Early detection of Adriamycin-induced cardiac dysfunction is crucial in preventing heart failure through interventions such as angiotensin-converting enzyme inhibitors and beta-blockers. Adriamycin-induced cardiotoxicity is classified into Type I (irreversible, involving cardiomyocyte necrosis) and Type II (potentially reversible, involving cardiomyocyte dysfunction). Type I toxicity is more common, leading to long-term heart cell necrosis. Monitoring cardiac function in children receiving Adriamycin is essential. Non-invasive imaging techniques like transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography are used to evaluate left ventricular (LV) systolic and diastolic functions. However, the role of cardiac Troponin I for early detection of anthracycline-induced cardiomyopathy remains debated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This prospective study included 50 children (26 males, 24 females) with a median age of 8 years (range: 2\u201314) receiving Adriamycin. Troponin I levels were measured before and 24 hours after Adriamycin administration. Standard Doppler Echocardiography and Tissue Doppler Imaging (TDI) were performed at baseline, one month, and six months\u2019 post-treatment to assess LV function.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Out of 50 patients, two showed a decrease in left ventricular ejection fraction (LVEF) below the normal range (&lt;55%) one month post-treatment, along with significant increases in Troponin I levels. No significant decline in LVEF was observed at one or six months\u2019 post-treatment using Standard Doppler Echocardiography. However, TDI revealed a decrease in LV systolic and diastolic function in all patients one month after Adriamycin administration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>TDI is more sensitive than Standard Doppler Echocardiography in detecting Adriamycin-induced cardiotoxicity. Elevated cardiac Troponin I levels correlate with a decline in LVEF, but subclinical cardiac dysfunction is better detected with TDI.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0328632","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T17:40:27Z","timestamp":1754588427000},"page":"e0328632","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early 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