| Title: |
Comprehensive echocardiographic detection of treatment-related cardiac dysfunction in adult survivors of childhood cancer: results from the St. Jude Lifetime Cohort Study |
| Authors: |
Armstrong, GT; Joshi, VM; Ness, KK; Thomas Marwick; Zhang, N; Srivastava, D; Griffin, BP; Grimm, RA; Thomas, J; Phelan, D; Collier, P; Krull, KR; Mulrooney, DA; Green, DM; Hudson, MM; Robison, LL; Plana, JC |
| Publication Year: |
2015 |
| Subject Terms: |
Cardiology (incl. cardiovascular diseases); cardiomyopathy; cardiotoxicity; heart failure; late effects; screening; strain |
| Description: |
Background: Treatment-related cardiac death is the primary, noncancer cause of mortality in adult survivors of childhood malignancies. Early detection of cardiac dysfunction may identify a high-risk subset of survivors for early intervention. Objectives: This study sought to determine the prevalence of cardiac dysfunction in adult survivors of childhood malignancies. Methods: Echocardiographic assessment included 3-dimensional (3D) left ventricular ejection fraction (LVEF), global longitudinal and circumferential myocardial strain, and diastolic function, graded per American Society of Echocardiography guidelines in 1,820 adult (median age 31 years; range: 18 to 65 years) survivors of childhood cancer (median time from diagnosis 23 years; range: 10 to 48 years) exposed to anthracycline chemotherapy ( n = 1,050), chest-directed radiotherapy ( n = 306), or both ( n = 464). Results: Only 5.8% of survivors had abnormal 3D LVEFs (30 Gy (RR: 2.39; 95% CI: 1.79 to 3.18) and anthracycline dose > 300 mg/m 2 (RR: 1.72; 95% CI: 1.31 to 2.26). Survivors with metabolic syndrome were twice as likely to have abnormal global longitudinal strain (RR: 1.94; 95% CI: 1.66 to 2.28) and abnormal diastolic function (RR: 1.68; 95% CI: 1.39 to 2.03) but not abnormal 3D LVEFs (RR: 1.07; 95% CI: 0.74 to 1.53). Conclusions: Abnormal global longitudinal strain and diastolic function are more prevalent than reduced 3D LVEF and are associated with treatment exposure. They may identify a subset of survivors at higher risk for poor clinical cardiac outcomes who may benefit from early medical intervention. |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
102.100.100/572932 |
| Availability: |
https://figshare.com/articles/journal_contribution/Comprehensive_echocardiographic_detection_of_treatment-related_cardiac_dysfunction_in_adult_survivors_of_childhood_cancer_results_from_the_St_Jude_Lifetime_Cohort_Study/22925960 |
| Rights: |
In Copyright |
| Accession Number: |
edsbas.17FBABC4 |
| Database: |
BASE |