Key result
Childhood Hodgkin lymphoma survivors exhibited significant systolic and diastolic dysfunction compared to healthy controls, including decreased peak E' velocity (12.4 vs 13.3 cm/s; P=0.03).
Why the study?
Do long-term survivors of childhood Hodgkin lymphoma have impaired systolic and diastolic cardiac functions compared to healthy children?
Case-Control (n=72)
Do long-term survivors of childhood Hodgkin lymphoma have impaired systolic and diastolic cardiac functions compared to healthy children?
Long-term survivors of childhood Hodgkin lymphoma exhibit subclinical systolic and diastolic dysfunction on tissue Doppler imaging compared to healthy controls.
Supports monitoring for subclinical dysfunction in survivors; leaves open whether findings predict events or guide interventions.
BACKGROUND: Monitoring for late adverse events is crucial in long-term management of childhood cancer survivors. A case-control study to evaluate long-term cardiovascular status of childhood Hodgkin lymphoma (HL) using tissue Doppler imaging (TDI) was performed. PATIENTS AND METHODS: Patients diagnosed with HL before age of 18 that completed therapy and were in remission and a control group of healthy children were evaluated by echocardiography and TDI. RESULTS: Total of 72 HL survivors were included in the study. Median age at diagnosis, remission time, and age at time of echocardiography were 7 (2-16), 9 (2-20), and 17.5 (7-27) years, respectively. TDI revealed decreased S' velocity, reflecting systolic dysfunction in HL survivors, at medial and lateral mitral annuli and at middle segment of interventricular septum (IVS; P < 0.01) for all. Moreover, TDI showed decreased peak E' velocity at medial mitral annulus [12.4 cm/s (5.5-16.3) vs. 13.3 cm/s (10.2-18.9), P = 0.03] and at middle segment of IVS [10 cm/s (5.3-16.3) vs. 11.6 cm/s (6.7-16.7), P < 0.01] and prolongation of isovolemic relaxation time at medial and lateral annuli of the mitral valve (P < 0.01) and at middle segment of IVS (P = 0.03) suggesting diastolic dysfunction in HL survivors. CONCLUSION: Cardiac dysfunction after childhood cancer therapy may develop after many years. Since systolic and diastolic dysfunction can be seen in these patients periodic echocardiographic screening of both systolic and diastolic function in the survivors of HL might be useful in the follow-up of these patients.
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Alehan et al. (2011) conducted a case-control in Childhood Hodgkin lymphoma survivors (n=72). Prior childhood Hodgkin lymphoma therapy vs. Healthy children was evaluated on Peak E' velocity at medial mitral annulus (cm/s) (p=0.03). Childhood Hodgkin lymphoma survivors exhibited significant systolic and diastolic dysfunction compared to healthy controls, including decreased peak E' velocity (12.4 vs 13.3 cm/s; P=0.03).
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