Childhood leukemia survivors exposed to anthracycline therapy had significantly lower peak LV torsion (P=0.003) and systolic twisting velocity (P<0.001) compared to healthy controls.
Case-Control (n=56)
Does prior anthracycline therapy alter left ventricular twisting and untwisting motion in childhood leukemia survivors compared to healthy controls?
Speckle tracking echocardiography reveals impaired left ventricular twisting and untwisting motion in childhood cancer survivors treated with anthracyclines, even when LV ejection fraction is preserved.
valor p: p=0.003
BACKGROUND: Anthracycline has been shown to degrade titin that plays a role in myocardial twisting and untwisting. This study aimed to test the hypothesis that left ventricular (LV) twisting and untwisting motion may be altered in children after anthracycline therapy. METHODS: Thirty-six childhood leukemia survivors aged 15.6 ± 5.5 years and 20 healthy controls aged 16.8 ± 7.7 years (P = 0.54) were studied. LV twisting and untwisting motion was determined using speckle tracking imaging, whereas LV ejection fraction and systolic and diastolic mitral annular velocities were determined respectively by three-dimensional and tissue-Doppler echocardiography. RESULTS: Compared with controls, patients had significantly lower LV ejection fraction (P = 0.01) but similar systolic and diastolic mitral annular velocities (all P > 0.05). Their peak LV torsion (P = 0.003), systolic twisting velocity (P 0.05). Twenty-eight (78%) patients had LV ejection fractions ≥50%. Although their systolic and diastolic mitral annular velocities were similar to those of controls, their peak LV torsion (P = 0.005), apical untwisting rate (P = 0.01), and LV systolic twisting velocity (P = 0.001) remained significantly lower. CONCLUSION: Impairment of LV twisting and untwisting motion is evident in children after anthracycline therapy, even in those with "normal" LV ejection fractions.
Cheung et al. (Mié,) realizaron un estudio de casos y controles en sobrevivientes de leucemia pediátrica después de la terapia con antraciclina (n=56). Se evaluó la terapia con antraciclina frente a controles sanos en la torsión máxima del ventrículo izquierdo, la velocidad de torsión sistólica y la velocidad de destorsión diastólica (p=0.003). Los sobrevivientes de leucemia infantil expuestos a la terapia con antraciclina tuvieron una torsión máxima del VI significativamente menor (P=0.003) y una velocidad de torsión sistólica menor (P<0.001) en comparación con los controles sanos.