Three-Dimensional Echocardiography and Cardiac Magnetic Resonance Imaging in the Screening of Long-Term Survivors of Childhood Cancer After Cardiotoxic Therapy - 15/05/14
, Anneli Eerola, MD, PhD a, Kim Vettenranta, MD, PhD c, d, Tuija Poutanen, MD, PhD a, bAbstract |
The left ventricular (LV) volumes, ejection fraction (EF), and dyssynchrony indexes for the 16 and 12 cardiac segments (Tmsv16-SD and Tmsv12-SD, respectively) were analyzed among nonadult, anthracycline-exposed long-term survivors of childhood cancer and compared with those of healthy controls using conventional and real-time 3-dimensional echocardiography (RT-3DE) with cardiac magnetic resonance (CMR) imaging in a prospective, cross-sectional, single tertiary center setting. Seventy-one survivors and gender-, body surface area-, and age-matched healthy controls were studied by conventional echocardiography and RT-3DE. Fifty-eight of the 71 survivors underwent also CMR. The survivors were evaluated in 2 groups. Group I consisted of 63 exposed to anthracyclines and group II consisted of 8 also exposed to cardiac irradiation. By RT-3DE, the group I survivors had a lower LVEF (57% vs 60%, respectively, p = 0.003) and larger body surface area–indexed LV end-systolic volume (31 vs 28 ml/m2, respectively, p = 0.001) than controls. The Tmsv16-SD was higher in group II than in I (1.93% vs 1.39%, respectively, p = 0.003). None of the survivors had an abnormal fractional shortening (<28%), but 10% had an LVEF <50% by RT-3DE. An LVEF <55% was detected in 45 of 58 (78%) of those imaged with CMR. In conclusion, RT-3DE seems to detect more abnormalities in cardiac function than conventional echocardiography following childhood cancer therapy. The LV dyssynchrony indexes derived from RT-3DE appear potentially useful in assessing the early signs of cardiotoxicity between anthracycline and cardiac irradiation exposed long-term survivors of childhood cancer.
Le texte complet de cet article est disponible en PDF.Plan
| This work was supported by the following Finnish foundations: the Blood Disease Research Foundation, Helsinki; the Competitive Research Funding of the Tampere University Hospital, 9L114 and 9N084, Tampere; the EVO funds of the Tampere University Hospital, Tampere; the Emil Aaltonen Foundation, Tampere; the Finnish Association of Hematology, Helsinki; the Finnish Cancer Foundation, Helsinki; the Finnish Cultural Foundation, Helsinki; the Finnish Cultural Foundation Pirkanmaa Regional Fund, Ylöjärvi; the Foundation for Pediatric Research, Helsinki; the National Graduate School of Clinical Investigations, Helsinki; the Päivikki and Sakari Sohlberg Foundation, Helsinki; the Scientific Foundation of the City of Tampere, Tampere; and the Väre Foundation for Pediatric Cancer, Helsinki. |
|
| See page 1891 for disclosure information. |
Vol 113 - N° 11
P. 1886-1892 - juin 2014 Retour au numéro
Article précédent
- Differences in Global and Regional Left Ventricular Myocardial Mechanics in Various Morphologic Subtypes of Patients With Obstructive Hypertrophic Cardiomyopathy Referred for Ventricular Septal Myotomy/Myectomy
- Taisei Kobayashi, Ashwat Dhillon, Zoran Popovic, Aditya Bhonsale, Nicholas G. Smedira, Maran Thamilarasan, Bruce W. Lytle, Harry M. Lever, Milind Y. Desai
- Incidence, Predictors, and Impact on Survival of Left Ventricular Systolic Dysfunction and Recovery in Advanced Cancer Patients
- Guilherme H. Oliveira, Siddarth Mukerji, Adrian V. Hernandez, Marwan Y. Qattan, Jose Banchs, Jean-Bernard Durand, Cezar Iliescu, Juan Carlos Plana, W.H. Wilson Tang
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?