Key result
In adult cancer survivors treated with anthracyclines, prior mediastinal radiotherapy was associated with a higher prevalence of abnormal global longitudinal strain (36.5% vs 14.6%, p=0.004).
Why the study?
Does two-dimensional speckle tracking echocardiography detect subclinical left ventricular systolic dysfunction better than standard LVEF in adult survivors of childhood cancer?
Cross-Sectional (n=134)
Does two-dimensional speckle tracking echocardiography detect subclinical left ventricular systolic dysfunction better than standard LVEF in adult survivors of childhood cancer?
Two-dimensional speckle tracking echocardiography frequently detects subclinical left ventricular systolic dysfunction in adult cancer survivors despite a normal LVEF, particularly in those who received mediastinal radiotherapy.
Answers are grounded in this paper and cite their sources.
May support intensified GLS monitoring in anthracycline survivors with mediastinal radiotherapy; leaves open prospective validation.
Two-dimensional speckle tracking echocardiography (2DSTE) provides a sensitive measure of left ventricular (LV) systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: 31.4 ± 8.8 years; 55% male; mean time since diagnosis: 15.4 ± 9.4 years) previously treated with anthracyclines (mean cumulative dose: 320 ± 124 mg/m(2)), with (n = 52) or without (n = 82) mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF) < 55%, and global longitudinal strain (GLS) ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18%) patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, p = 0.003) and prevalence of abnormal GLS was higher (36.5% versus 14.6%, p = 0.004) in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS (p = 0.040) after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors.
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Yu et al. (2016) conducted a cross-sectional in Adult survivors of childhood, adolescent, and young adult cancer (n=134). Mediastinal radiotherapy vs. No mediastinal radiotherapy was evaluated on Prevalence of abnormal global longitudinal strain (GLS ≤ 16%) (p=0.004). In adult cancer survivors treated with anthracyclines, prior mediastinal radiotherapy was associated with a higher prevalence of abnormal global longitudinal strain (36.5% vs 14.6%, p=0.004).
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