Key result
Left ventricular global longitudinal strain was the most sensitive predictor of anthracycline-related cardiotoxicity in children with lymphoma, with an absolute value <17.67 yielding a sensitivity of 76.5% and specificity of 91.7%.
Why the study?
To assess changes in left myocardial function after chemotherapy for childhood lymphoma and evaluate speckle-tracking echocardiography for predicting or monitoring cancer treatment-related cardiac dysfunction.
Does speckle-tracking echocardiography predict doxorubicin cardiotoxicity in children with lymphoma?
Case-Control (n=46)
No
Does speckle-tracking echocardiography predict doxorubicin cardiotoxicity in children with lymphoma?
Left ventricular global longitudinal strain (LVGLS) is a sensitive early indicator for predicting doxorubicin-induced cardiotoxicity in children with lymphoma.
Answers are grounded in this paper and cite their sources.
LVGLS may aid early detection in pediatric lymphoma; hypothesis-generating and requires prospective validation before practice change.
Objectives The objectives of this study were to assess the changes in the left myocardial function after chemotherapy for childhood lymphoma and observe the predictive or monitor value for cancer treatment-related cardiac dysfunction (CTRCD) by speckle-tracking echocardiography. Methods A total of 23 children with histopathological diagnoses of lymphoma were included, with age-matched normal controls. Comparative analysis of clinical serological tests and left heart strain parameters in children with lymphoma, including left ventricular global longitudinal strain (LVGLS); global myocardial work (GMW) indices, which include global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency; and the LS of subendocardial, middle, and subepicardial layer myocardium during left ventricular systole were measured: left atrial strain of reservoir phase (LASr), left atrial strain of conduit phase (LAScd), and left atrial strain of contraction phase (LASct). Results One-way ANOVA showed that GLS, GWI, GCW, LASr, and LAScd were closely associated with CTRCD and multivariate logistic regression analysis showed that GLS was the most sensitive predictor for detecting patients at lofty risk of anthracycline-related cardiotoxicity. Both before and after chemotherapy, GLS in the left ventricle showed a pattern of basal segment < middle segment < apical segment and subepicardial < middle < subendocardial layer (p < 0.05), and the degree of decrease also showed a regular pattern of epicardial layer < middle layer < subendocardial layer while the difference was not significant (p > 0.05). After chemotherapy, maximum flow rate in early mitral relaxation/left atrial systolic maximum flow rate (E/A) and left atrial volume index of each group were in the normal range, and the values of LASr, LAScd, and LASct slightly increased in the second cycle and decreased significantly in the fourth cycle after chemotherapy, reaching the lowest level; LASr and LAScd were positively correlated with GLS. Conclusion LVGLS is a more sensitive and earlier indicator to predict CTRCD compared with conventional echocardiography-related parameters and serological markers, and GLS of each myocardial layer showed a certain regularity. Left atrial strain can be used for early monitoring of cardiotoxicity in children with lymphoma after chemotherapy.
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Chen et al. (2023) conducted a case-control in Lymphoma (n=46). Anthracycline chemotherapy vs. Healthy controls was evaluated on Prediction of cancer treatment-related cardiac dysfunction (CTRCD) (OR 0.381, p=<0.05). Left ventricular global longitudinal strain was the most sensitive predictor of anthracycline-related cardiotoxicity in children with lymphoma, with an absolute value <17.67 yielding a sensitivity of 76.5% and specificity of 91.7%.
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