Key result
At ≥5 years post-anthracycline treatment, 54% of childhood ALL survivors had a ≥10% relative reduction in longitudinal strain, with significantly lower strain values than healthy controls.
Why the study?
Does anthracycline treatment reduce myocardial 2D strain in childhood survivors of acute lymphoblastic leukemia at long-term follow-up?
Cohort
Does anthracycline treatment reduce myocardial 2D strain in childhood survivors of acute lymphoblastic leukemia at long-term follow-up?
Childhood survivors of ALL treated with anthracyclines demonstrate ongoing subclinical myocardial dysfunction detectable by 2D strain imaging at long-term follow-up, despite preserved left ventricular ejection fraction.
Persistent subclinical strain reduction occurs long-term after anthracyclines despite preserved EF; hypothesis-generating for strain surveillance, prospective studies needed.
), shortly after (T = 2) and long after anthracycline treatment (T = 3, ≥5 years after anthracycline exposure). Cardiac function of survivors at the latest follow up was compared with 70 healthy age-matched controls. None of the survivors showed clinical signs of cardiac failure at T = 3. Strain values decreased during anthracycline treatment and an ongoing reduction was seen at the latest follow-up (T = 3) with preserved cardiac function (normal ejection fraction and shortening fraction). At T = 1, a relative reduction in longitudinal strain (≥10% compared with baseline) was observed in 38% of the survivors, which increased to 54% at T=3. ALL survivors showed significantly lower conventional and myocardial 2D strain values, especially strain rate, compared with healthy age-matched controls. At T = 3, we did not find any abnormal cardiac troponin T levels. Six percent of the survivors showed abnormal N-terminal-pro-brain natriuretic peptide levels. This prospective study showed an ongoing reduction of 2D myocardial strain and strain rate, with preserved left ventricular ejection fraction (≤10% decrease compared with baseline) in asymptomatic ALL survivors at late follow-up.
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Pourier et al. (2020) conducted a cohort in Acute Lymphoblastic Leukemia. Anthracycline treatment vs. Healthy age-matched controls was evaluated on Myocardial 2D strain and strain rate. At ≥5 years post-anthracycline treatment, 54% of childhood ALL survivors had a ≥10% relative reduction in longitudinal strain, with significantly lower strain values than healthy controls.
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