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November 27, 2019Cardiology in the Young

Left ventricle segmental function in childhood cancer survivors using speckle-tracking echocardiography

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Why the study?

Anthracycline-associated cardiotoxicity in childhood cancer survivors may relate to global or segmental left ventricular abnormalities from thromboembolic events and myocardial microinfarcts.

Does prior anthracycline chemotherapy cause subclinical global or segmental left ventricular dysfunction in asymptomatic childhood cancer survivors?

Population

41 childhood cancer survivors with normal LV fractional shortening >1 year after anthracycline chemotherapy and cancer-free controls

Comparison

Anthracycline-treated childhood cancer survivors vs cancer-free control children

Design

Case-control study

Follow-up

Median 4.73 years

Key result

In 2017, an estimated 1,688,780 new cancer cases and 600,920 cancer deaths are expected to occur in the United States, with overall cancer death rates having declined by 25% from 1991 to 2014.

Authors

JAJyothsna Akam‐VenkataGKGilda KadiuJGJames Galas

Discussion

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Member takes

Overview

Subclinical LV strain reduction occurs in anthracycline-treated survivors despite normal FS; leaves open whether routine speckle-tracking screening improves outcomes.

Structured PICO

Does prior anthracycline chemotherapy cause subclinical global or segmental left ventricular dysfunction in asymptomatic childhood cancer survivors?

P
Population
Estimated 1,688,780 new cancer cases and 600,920 cancer deaths expected to occur in the United States in 2017.
E
Exposure
Prior anthracycline chemotherapy (median cumulative dose 160.2 mg/m2)
C
Comparator
Cancer-free control children with normal echocardiograms
O
Outcome
Left ventricular segmental and global strain (longitudinal, radial, and circumferential) measured by two-dimensional speckle-tracking echocardiographysurrogate

Speckle-tracking echocardiography reveals subclinical global left ventricular dysfunction in asymptomatic childhood cancer survivors treated with anthracyclines, even when conventional fractional shortening is normal.

Limitations

  • Estimates are offered as a rough guide and should be interpreted with caution.
  • State estimates may not add to US total due to rounding.
  • Estimates do not include carcinoma in situ of any site except urinary bladder, nor basal cell or squamous cell skin cancers.

Cite This Study

Akam‐Venkata et al. (2019) conducted a review in Cancer (n=1,688,780). In 2017, an estimated 1,688,780 new cancer cases and 600,920 cancer deaths are expected to occur in the United States, with overall cancer death rates having declined by 25% from 1991 to 2014.

synapsesocial.com/papers/6a46fed0f81ec6c7245ed13dhttps://doi.org/10.1017/s1047951119002622
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