Guideline for Serial Monitoring of LVEF by ERNA for Patients Undergoing Chemotherapy with Anthracyclines (9,10)
Normal LVEF at baseline (≥50%) |
Baseline ERNA before initiating chemotherapy |
Next ERNA at 250–300 mg/m2 dose |
Next ERNA at 450 mg/m2 (400 mg/m2 if high risk*) |
Next ERNA before each dose > 450 mg/m2 |
Discontinue therapy if LVEF decreases ≥10% (EF units) from baseline and reaches <50% |
Abnormal LVEF at baseline (>30% to <50%) |
Baseline ERNA before initiating chemotherapy |
Serial ERNA before each subsequent dose |
Discontinue therapy if LVEF decreases ≥ 10% (EF units) from baseline or reaches ≤ 30% |
LVEF ≤ 30% at baseline |
Do not initiate therapy |
↵* High-risk features include use of cyclophosphamide, heart disease, mediastinal radiation, and abnormal ECG.