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Left ventricle segmental function in childhood cancer survivors using speckle-tracking echocardiography.
Akam-Venkata, Jyothsna; Kadiu, Gilda; Galas, James; Lipshultz, Steven E; Aggarwal, Sanjeev.
Afiliação
  • Akam-Venkata J; Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
  • Kadiu G; Division of Cardiology, Children's Hospital of Michigan, Detroit, MI, USA.
  • Galas J; Division of Cardiology, Children's Hospital of Michigan, Detroit, MI, USA.
  • Lipshultz SE; Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
  • Aggarwal S; Division of Cardiology, Children's Hospital of Michigan, Detroit, MI, USA.
Cardiol Young ; 29(12): 1494-1500, 2019 Dec.
Article em En | MEDLINE | ID: mdl-31771663
ABSTRACT

AIM:

Anthracycline-associated cardiotoxicity in childhood cancer survivors may relate to global or segmental left ventricular abnormalities from associated thromboembolic events and myocardial microinfarcts. We characterized left ventricular segmental changes by two-dimensional speckle-tracking echocardiography in anthracycline-treated asymptomatic childhood cancer survivors. METHODS AND

RESULTS:

Childhood cancer survivors' echocardiograms with normal left ventricular fractional shortening >1 year after anthracycline chemotherapy were studied. Cancer-free control children had normal echocardiograms. Apical two-, three-, and four-chamber peak systolic left ventricular longitudinal and global longitudinal strain, and peak systolic left ventricular radial and circumferential strain at papillary muscle levels were analyzed. The mean (standard deviation) age was 12.7 (3.8) years in 41 childhood cancer survivors. The median (interquartile range) follow-up after anthracycline chemotherapy was 4.73 (2.15-8) years. The median (range) cumulative anthracycline dose was 160.2 (60-396.9) mg/m2. In childhood cancer survivors, the mean (standard deviation) left ventricular longitudinal strain was lower in two- (-18.6 [3.2] versus -21.3 [2.5], p < 0.001), three- (-16.3 [6.0] versus -21.7 [3.0], p < 0.001), and four- (-17.6 [2.7] versus -20.8 [2.0], p < 0.001) chamber views compared to controls. The left ventricular global longitudinal strain (-17.6 [2.7] versus -21.3 [2.0]) and circumferential strain (-20.8 [4.3] versus -23.5 [2.6], p < 0.001) were lower in childhood cancer survivors. Among childhood cancer survivors, 12 out of 16 left ventricular segments had significantly lower longitudinal strain than controls.

CONCLUSIONS:

Asymptomatic anthracycline-treated childhood cancer survivors with normal left ventricular fractional shortening had lower global longitudinal and circumferential strain. The left ventricular longitudinal strain was lower in majority of the segments, suggesting that anthracycline cardiotoxicity is more global than regional.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ecocardiografia Doppler / Disfunção Ventricular Esquerda / Antraciclinas / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos / Ventrículos do Coração Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Cardiol Young Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / PEDIATRIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ecocardiografia Doppler / Disfunção Ventricular Esquerda / Antraciclinas / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos / Ventrículos do Coração Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Cardiol Young Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / PEDIATRIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos