Cancer Science & Therapy

Doxorubicin Cardiotoxicity and Cardiac Function Improvement After Stem Cell Therapy Diagnosed by Strain Echocardiography

Abstract

Maira S Oliveira, Marcos B Melo, Juliana L Carvalho, Isabela M Melo, Mario SL Lavor, Dawidson A Gomes, Alfredo M de Goes and Marilia M Melo

Doxorubicin (Dox) is one of the most effective chemotherapeutic agents; however, it causes dose-dependent
cardiotoxicity. Evaluation of left ventricular function relies on measurements based on M-mode echocardiography.
A new technique based on quantification of myocardial motion and deformation, strain echocardiography, has
been showed promising profile for early detection of cardiac dysfunction. Different therapy strategies, such as
flavonoid plant extracts and stem cells, have been investigated to improve heart function in toxic cardiomyopathy.
This work aimed to assess early cardiac function improvement after treatments with either flavonoid extract from
Camellia sinensis or mesenchymal stem cells in Dox cardiotoxicity using strain echocardiography. Twenty Wistar
rats were randomly assigned to four groups. They received water (control, Dox, Dox + stem cells) or 100 mg/kg
C. sinensis extract (Dox + C. sinensis) via gavage, daily, for four weeks. Animals also received saline (control)
or 5 mg/kg doxorubicin (Dox, Dox + C. sinensis, Dox + stem cells) via intraperitoneal injection, weekly, for four
weeks. Stem cells were injected (3 × 106 cells) through tail vein prior the beginning of the experiment (Dox + stem
cells). Animals were evaluated by hematological, electrocardiography, echocardiography, and histopathological
examinations. Dox cardiotoxicity was only diagnosed with strain echocardiography, detecting a decrease in
ventricular function. C. sinensis extract did not prevent ventricular dysfunction induced by Dox. However, strain
echocardiography examination revealed that Dox cardiotoxicity was significantly suppressed in rats treated with
stem cells. In conclusion, strain echocardiography was able to detect precocity signs of heart failure and stem cell
therapy showed cardioprotection effect against Dox cardiotoxicity.