Reversible myocardial dysfunction in a young woman with metastatic renal cell carcinoma treated with sunitinib

Figures & data

Figure 1.  MUltiple Gated Acquisition (MUGA) scan showing left ventricular ejection fraction (LVEF), end-diastolic (ED) diameter and end-systolic (ES) diameter at baseline.

Figure 2.  MUltiple Gated Acquisition (MUGA) scan showing left ventricular ejection fraction (LVEF), end-diastolic (ED) diameter and end-systolic (ES) diameter 1 year after the start of sunitinib treatment when cardiac symptoms appeared.

Table I.  Results of four tests of MUltiple Gated Acquisition (MUGA) blood pool in a patient with symptoms of heart failure after treatment with sunitinib.

Parameter	1st test(Baseline)	2nd test (1 year after starting sunitinib treatment)	3^rd test (6 months after starting therapy for cardiac symptoms)	4^th test (8 months after starting therapy for cardiac symptoms)
ED diameter (mm)	4 235	5 003	5 092	3 792
ES diameter (mm)	1 719	3 300	2 924	1 806
EF (%)	59	34	43	53
PFR (ED/s)	3.27	0.99	1.89	2.09
TPFR (ms)	110	200	115	135
PER (ED/s)	3.02	2.10	2.52	2.50
TPER (ms)	110	140	160	240
FF (%ED)	85	88	91	88

ED = end-diastolic; ES = end-systolic; EF = ejection fraction; PFR = peak filling rate; ED/s = maximum change of initial ED volume during 1 second of PER or PFR; TPFR = time to PFR; ms = milliseconds; PER = peak ejection rate; TPER = time to PER; FF = filtration fraction.

Figure 3.  MUltiple Gated Acquisition (MUGA) scan showing left ventricular ejection fraction (LVEF), end-diastolic (ED) diameter and end-systolic (ES) diameter 6 months after the start of therapy for cardiac symptoms.

Figure 4.  MUltiple Gated Acquisition (MUGA) scan showing left ventricular ejection fraction (LVEF), end-diastolic (ED) diameter and end-systolic (ES) diameter 8 months after the start of therapy for cardiac symptoms.