Correlating decline in left ventricular ejection fraction and longitudinal strain in pediatric cancer patients.

Autor: Sanchez Mejia AA; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Pignatelli RH; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Rainusso N; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA.; Division of Pediatric Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine Feigin Center, 1102 Bates St., Suite 1030.07, 77030, Houston, TX, USA., Lilje C; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Sachdeva S; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Tunuguntla HP; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Doan TT; Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, 6651 Main St. Suite E1920, 77030, Houston, TX, USA.; Texas Children's Hospital, 6621 Fannin St, 77030, Houston, TX, USA., Gandhi AA; Baylor College of Medicine, One Baylor Plaza, 77030, Houston, TX, USA., Walters NC; Baylor College of Medicine, One Baylor Plaza, 77030, Houston, TX, USA., Trajtenberg DP; Boston University, 64 Cummington Mall, room 149, 02215, Boston, MA, USA., Loar RW; Cook Children's Medical Center, 801 7th Ave, 76104, Fort Worth, TX, USA.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2023 Apr; Vol. 39 (4), pp. 747-755. Date of Electronic Publication: 2022 Dec 21.
DOI: 10.1007/s10554-022-02780-z
Abstrakt: Purpose: Left ventricular ejection fraction (LVEF) is routinely used to monitor cardiac function in cancer patients. Global longitudinal strain (GLS) detects subclinical myocardial dysfunction. There is no consensus on what constitutes a significant change in GLS in pediatric cancer patients. We aim to determine the change in GLS associated with a simultaneous decline in LVEF in pediatric cancer patients.
Methods: This is a retrospective longitudinal study of pediatric cancer patients treated with anthracyclines between October 2017 and November 2019. GLS was measured by 2-dimensional speckle tracking. The study outcome was a decline in LVEF, defined as a decrease in LVEF of ≥ 10% points from baseline or LVEF < 55%. We evaluated two echocardiograms per patient, one baseline, and one follow-up. The follow-up echocardiogram was either (1) the first study that met the outcome or (2) the last echocardiogram available in patients without the outcome. Statistical analyses included receiver operator characteristic curves and univariable and multivariable Cox proportional hazards regression.
Results: Out of 161 patients, 33 (20.5%) had a decline in LVEF within one year of follow-up. GLS reduction by ≥ 15% from baseline and follow-up GLS >-18% had sensitivities of 85% and 78%, respectively, and specificities of 86% and 83%, respectively, to detect LVEF decline. GLS reduction by ≥ 15% from baseline and follow-up GLS >-18% were independently associated with simultaneous LVEF decline [hazard ratio (95% confidence intervals): 16.71 (5.47-51.06), and 12.83 (4.62-35.63), respectively].
Conclusion: Monitoring GLS validates the decline in LVEF in pediatric cancer patients.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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