Evaluation of Cardiotoxic Effects of Anthracyclines by Tissue Doppler Imaging in Survivors of Childhood Cancer.

Autor: Caliskan M; Department of Pediatrics, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey., Kosger P; Department of Pediatric Cardiology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey., Ozdemir ZC; Department of Pediatric Hematology and Oncology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey., Ucar B; Department of Pediatric Cardiology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey., Bor O; Department of Pediatric Hematology and Oncology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey.
Jazyk: angličtina
Zdroj: Turkish archives of pediatrics [Turk Arch Pediatr] 2021 Sep; Vol. 56 (5), pp. 492-498.
DOI: 10.5152/TurkArchPediatr.2021.20233
Abstrakt: Background: Childhood cancer survivors (CCSs) are at risk for anthracycline-induced cardiotoxicity which tends to be more prominent long after completion of the chemotherapy. The aim of this study was to examine echocardiographic parameters of anthracycline-induced subclinical cardiotoxicity in children who had received chemotherapy.
Materials and Methods: A cross-sectional single-center study was conducted in a tertiary level university hospital in Eskisehir, Turkey. A total of 50 CCSs and 40 healthy peers were included. The CCSs were divided into 3 subgroups according to cumulative anthracycline dose (100-200 mg/m2, 201-299 mg/m2, and ≥ 300 mg/m2). Biventricular cardiac examination was performed with conventional echocardiography and tissue Doppler echocardiography imaging (TDI).
Results: The mean duration from termination of chemotherapy to echocardiographic assessment was 3.9 ± 2.2 years. The mean age of the CCSs was 11.6 ± 3.9 years. TDI-derived mitral annular isovolumetric relaxation time (IVRT) and myocardial performance index (MPI) were higher in the high-dose group of CCSs than in controls (P = .006, P = .007, P < .001, P = .0014, respectively). IVRT was also higher in patients with ≥ 300 mg/m2 cumulative dose than in those with < 200 mg/m2 (P = .007). TDI-derived mitral annular MPI and IVRT were significantly associated with cumulative anthracycline dose (r = 0.288, P = .006, r = 0.340, P = .001).
Conclusion: A cumulative anthracycline dose > 300 mg/m2 may lead to subclinical cardiotoxicity, and is therefore a potential risk factor for late onset cardiac failure. TDI-derived MPI can be a sensitive tool to reveal subtle signs of myocardial damage, which may facilitate implementation of preventive therapies for patients suspected to be at risk.
Databáze: MEDLINE
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