Left atrial function in children and young adult cancer survivors treated with anthracyclines

被引:15
作者
Patel, Nisha R. [1 ,2 ]
Chyu, Christopher K. [3 ,4 ]
Satou, Gary M. [3 ]
Halnon, Nancy J. [3 ]
Kim-Lien Nguyen [1 ,2 ]
机构
[1] UCLA, David Geffen Sch Med, Div Cardiol, Los Angeles, CA 90073 USA
[2] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA
[3] UCLA, David Geffen Sch Med, Mattel Childrens Hosp, Div Pediat Cardiol, Los Angeles, CA 90073 USA
[4] Univ Calif San Francisco, Benioff Childrens Hosp, Div Pediat Cardiol, San Francisco, CA 94143 USA
来源
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES | 2018年 / 35卷 / 10期
关键词
anthracycline; atrial strain; cardiotoxicity; left atrial ejection fraction; left atrium; two-dimensional speckle tracking echocardiography; SPECKLE-TRACKING ECHOCARDIOGRAPHY; INDUCED CARDIOTOXICITY; VENTRICULAR-FUNCTION; LONGITUDINAL STRAIN; CHEMOTHERAPY; CHILDHOOD; LEUKEMIA; THERAPY;
D O I
10.1111/echo.14100
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe left atrium (LA) modulates left ventricular filling pressure and is a strong prognosticator in heart failure. Although anthracycline exposure may lead to impaired left ventricular (LV) function, the effects on LA function are not well-described in the younger population. We aim to evaluate LA function in children exposed to anthracyclines. MethodsChildren exposed to anthracyclines with pre- and post-treatment echocardiographic imaging were enrolled. Measures of LA function (LA ejection fraction [LA EF], global longitudinal strain [GLS], and peak GLS rate) were quantified using 2D speckle tracking echocardiography pre- and post-anthracycline therapy and were compared. Segments with poor tracking were excluded. ResultsFifty-five children (age 13 [SD 5] years) treated with anthracyclines were evaluated. LA EF, GLS, and peak GLS rate were lower after anthracycline exposure. Mean changes were as follows: LA EF (pre-73.5 [SD 7.7]% vs post-70.6 [SD 8.2]%, P=0.06), GLS (-34.2 [SD 8.4]% vs -31.9 [SD 7.1]%, P=0.09), peak GLS rate (2.2 [SD 0.8]s(-1) vs 2.0 [SD 0.6]s(-1), P=0.18). When stratified by pre- (12years old) vs post-puberty (>12years old), prepubescent patients (n=21) had statistically significant changes in pre/post LA GLS (P=0.01) and LA EF (P=0.01). In models adjusted for radiation dose, age, gender, body surface area, or cumulative anthracycline dose, there were no significant relationships in the absolute difference between pre/post LA EF (P=0.34) or LA GLS (P=0.18). ConclusionsIn children exposed to anthracyclines, short-term effects on LA function were minimal in those with preserved LV EF. Age-dependent LA susceptibility to anthracycline requires further study.
引用
收藏
页码:1649 / 1656
页数:8
相关论文
共 32 条
[1]  
Abd M, 2017, THORAC CARDIOVASC SU, V65, pS111
[2]   Acute Leukemia is Associated with Cardiac Alterations before Chemotherapy [J].
Assuncao, Bruna Morhy Borges Leal ;
Handschumacher, Mark D. ;
Brunner, Andrew M. ;
Yucel, Evin ;
Bartko, Philipp E. ;
Cheng, Kai-Hung ;
Campos, Orlando ;
Fathi, Amir T. ;
Tan, Timothy C. ;
Scherrer-Crosbie, Marielle .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2017, 30 (11) :1111-1118
[3]   Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction [J].
Ayoub, Amal Mohamed ;
Keddeas, Viola William ;
Ali, Yasmin Abdelrazek ;
El Okl, Reham Atef .
CLINICAL MEDICINE INSIGHTS-CARDIOLOGY, 2016, 10 :85-90
[4]   Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking [J].
Cameli, Matteo ;
Caputo, Maria ;
Mondillo, Sergio ;
Ballo, Piercarlo ;
Palmerini, Elisabetta ;
Lisi, Matteo ;
Marino, Enzo ;
Galderisi, Maurizio .
CARDIOVASCULAR ULTRASOUND, 2009, 7
[5]   Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines [J].
Curigliano, G. ;
Cardinale, D. ;
Suter, T. ;
Plataniotis, G. ;
de Azambuja, E. ;
Sandri, M. T. ;
Criscitiello, C. ;
Goldhirsch, A. ;
Cipolla, C. ;
Roila, F. ;
Grp, E. S. M. O. Guidelines Working .
ANNALS OF ONCOLOGY, 2012, 23 :155-166
[6]   Assessment of late anthracycline-induced cardiotoxicity by 123I-mIBG cardiac scintigraphy in patients treated during childhood and adolescence [J].
dos Santos, Marcelo Jose ;
da Rocha, Euclides Timoteo ;
Verberne, Hein J. ;
da Silva, Eduardo Tinois ;
Aragon, Davi Casale ;
Soares Junior, Jose .
JOURNAL OF NUCLEAR CARDIOLOGY, 2017, 24 (01) :256-264
[7]   Assessment of left atrial function by MRI myocardial feature tracking [J].
Evin, Morgane ;
Cluzel, Philippe ;
Lamy, Jerome ;
Rosenbaum, David ;
Kusmia, Slawek ;
Defrance, Carine ;
Soulat, Gilles ;
Mousseaux, Elie ;
Roux, Charles ;
Clement, Karine ;
Hatem, Stephane N. ;
Redheuil, Alban ;
Kachenoura, Nadjia .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2015, 42 (02) :379-389
[8]   Long-Term Cardiac Safety of Dose-Dense Anthracycline Therapy Cannot Be Predicted From Early Ejection Fraction Data [J].
Ewer, Michael S. ;
Ewer, Steven M. .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (36) :6073-6075
[9]   Mesenchymal stem cell therapy for doxorubicin cardiomyopathy: hopes and fears [J].
Ezquer, Fernando ;
Gutierrez, Jaime ;
Ezquer, Marcelo ;
Caglevic, Christian ;
Salgado, Helio C. ;
Calligaris, Sebastian D. .
STEM CELL RESEARCH & THERAPY, 2015, 6
[10]   Myocardial dysfunction late after low-dose anthracycline treatment in asymptomatic pediatric patients [J].
Ganamc, Javier ;
Clalis, Piet ;
Uyttebroeck, Anne ;
Renard, Marleen ;
D'hooge, Jan ;
Bijnens, Bart ;
Sutherland, George R. ;
Eyskens, Benedicte ;
Mertens, Luc .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2007, 20 (12) :1351-1358