Key result
Cumulative anthracycline doses ≥300 mg/m2 in childhood cancer survivors were associated with higher TDI-derived mitral annular IVRT and MPI compared to healthy controls (P<0.001).
Why the study?
Childhood cancer survivors are at risk for anthracycline-induced cardiotoxicity, which tends to become more prominent long after completing chemotherapy.
Does prior anthracycline chemotherapy increase echocardiographic markers of subclinical cardiotoxicity in childhood cancer survivors compared to healthy peers?
Cross-Sectional (n=90)
No
Does prior anthracycline chemotherapy increase echocardiographic markers of subclinical cardiotoxicity in childhood cancer survivors compared to healthy peers?
p-value: p=<0.001
Tissue Doppler imaging can detect subclinical left ventricular diastolic dysfunction in childhood cancer survivors exposed to high cumulative doses of anthracyclines, even when conventional echocardiography appears normal.
BACKGROUND: Childhood cancer survivors (CCSs) are at risk for anthracycline-induced cardiotoxicity which tends to be more prominent long after completion of the chemotherapy. The aim of this study was to examine echocardiographic parameters of anthracycline-induced subclinical cardiotoxicity in children who had received chemotherapy. MATERIALS AND METHODS: A cross-sectional single-center study was conducted in a tertiary level university hospital in Eskisehir, Turkey. A total of 50 CCSs and 40 healthy peers were included. The CCSs were divided into 3 subgroups according to cumulative anthracycline dose (100-200 mg/m2, 201-299 mg/m2, and ≥ 300 mg/m2). Biventricular cardiac examination was performed with conventional echocardiography and tissue Doppler echocardiography imaging (TDI). RESULTS: The mean duration from termination of chemotherapy to echocardiographic assessment was 3.9 ± 2.2 years. The mean age of the CCSs was 11.6 ± 3.9 years. TDI-derived mitral annular isovolumetric relaxation time (IVRT) and myocardial performance index (MPI) were higher in the high-dose group of CCSs than in controls (P = .006, P = .007, P < .001, P = .0014, respectively). IVRT was also higher in patients with ≥ 300 mg/m2 cumulative dose than in those with < 200 mg/m2 (P = .007). TDI-derived mitral annular MPI and IVRT were significantly associated with cumulative anthracycline dose (r = 0.288, P = .006, r = 0.340, P = .001). CONCLUSION: A cumulative anthracycline dose > 300 mg/m2 may lead to subclinical cardiotoxicity, and is therefore a potential risk factor for late onset cardiac failure. TDI-derived MPI can be a sensitive tool to reveal subtle signs of myocardial damage, which may facilitate implementation of preventive therapies for patients suspected to be at risk.
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ÇALIŞKAN et al. (2023) conducted a cross-sectional in Anthracycline-induced cardiotoxicity (n=90). Cumulative anthracycline dose vs. Healthy peers and lower dose groups was evaluated on TDI-derived mitral annular isovolumetric relaxation time (IVRT) and myocardial performance index (MPI) (p=<0.001). Cumulative anthracycline doses ≥300 mg/m2 in childhood cancer survivors were associated with higher TDI-derived mitral annular IVRT and MPI compared to healthy controls (P<0.001).
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