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August 6, 2021International journal of cardiac imagingOpen Access

Left ventricular dyssynchrony in long-term childhood cancer survivors treated with anthracyclines: a retrospective cross-sectional study

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Why the study?

Left ventricular contraction patterns had not been evaluated in asymptomatic childhood cancer survivors using two-dimensional speckle tracking echocardiography.

Does prior anthracycline therapy cause left ventricular dyssynchrony in asymptomatic childhood cancer survivors compared to healthy controls?

Population

115 asymptomatic childhood cancer survivors and 119 age matched healthy controls

Comparison

Childhood cancer survivors vs age matched healthy controls

Design

Retrospective cross-sectional study

Follow-up

Median 11.3 years (range 4.9-29.5)

Key result

Prior anthracycline exposure in asymptomatic childhood cancer survivors did not result in significant differences in left ventricular longitudinal or circumferential dyssynchrony compared to healthy controls.

Authors

MPMilanthy S. PourierMDMyrthe M. DullGWGert Weijers

Discussion

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Overview

LV dyssynchrony not increased in asymptomatic survivors; leaves open its role in anthracycline cardiotoxicity progression.

Study Design

Type

Cross-Sectional (n=234)

Multicenter

No

Structured PICO

Does prior anthracycline therapy cause left ventricular dyssynchrony in asymptomatic childhood cancer survivors compared to healthy controls?

P
Population
234 asymptomatic childhood cancer survivors previously treated with anthracyclines and healthy age-matched controls, with a median age of 17 years and median follow-up of 11.3 years.
E
Exposure
Prior anthracycline therapy (median cumulative dose 180 mg/m2)
C
Comparator
Age-matched healthy controls with no history of cardiac disease
O
Outcome
Left ventricular dyssynchrony measured by dyssynchrony index (DI) and difference between time to peak (T2P) systolic longitudinal strain of septal and lateral wall using 2D speckle tracking echocardiographysurrogate

Main Result

Absolute Event Rate: 3.05% vs 3.18%

p-value: p=0.41

In asymptomatic childhood cancer survivors treated with anthracyclines, 2D speckle tracking echocardiography did not reveal clinically significant left ventricular dyssynchrony compared to healthy controls, despite reduced global longitudinal strain.

Limitations

  • Small sample size of 115 childhood cancer survivors
  • Use of 2D speckle tracking echocardiography instead of more advanced techniques like 3D echocardiography or MRI
  • Limited by the use of only six segments for assessing dyssynchrony
  • Small sample size (115 CCS)
  • Use of 2DSTE instead of more advanced techniques like 3D echocardiography or MRI
  • Limited by use of only six segments for dyssynchrony assessment

Cite This Study

Pourier et al. (2021) conducted a cross-sectional in Childhood cancer survivors treated with anthracyclines (n=234). Anthracycline therapy vs. Healthy age-matched controls was evaluated on Longitudinal dyssynchrony index (% heart cycle) (p=0.41). Prior anthracycline exposure in asymptomatic childhood cancer survivors did not result in significant differences in left ventricular longitudinal or circumferential dyssynchrony compared to healthy controls.

synapsesocial.com/papers/6a7af7138d250a4360f443cbhttps://doi.org/10.1007/s10554-021-02347-4
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors2022 · 8 citations
  2. 2Age-Related Impairment of Left Atrial Phasic Strain in Childhood Cancer Survivors Treated with Anthracyclines2026
  3. 3Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer2016 · 63 citations
  4. 4Left ventricle segmental function in childhood cancer survivors using speckle-tracking echocardiography2019 · 31 citations
  5. 5Cardiac Surveillance for Early Detection of Late Subclinical Cardiac Dysfunction in Childhood Cancer Survivors After Anthracycline Therapy2021 · 37 citations