Cardiovascular evaluation of patients undergoing cancer treatment at a clinic for childhood cancer survivors in Mexico

Objective: The objective of the study was to describe the cardiovascular effects of childhood cancer treatment in survivors through clinical, electrocardiogram, and echocardiographic methods. Materials and methods: Prospective, observational case-control study of 34 patients of a Childhood Cancer Survivors Clinic, evaluated clinically, with electrocardiogram, with conventional echocardiography and strain. Average age 13.03 years; the average cumulative dose of anthracyclics was 219.5 mg/m2; seven patients also received chest radiation. The analysis was done with Student's T-tests and linear regression. Results: Left ejection fraction (EF) in survivors was preserved. Longitudinal left strain in two, three chambers, and circumferential was decreased in survivors (p < 0.05). Those undergoing radiotherapy and anthracyclic presented increased heart rate, EF, left shortening fraction decreased (< 0.05), and right ventricle without significant changes. Discussion and conclusions: There are a large number of childhood cancer survivors treated with cardiotoxics and radiotherapy. They may present changes in ventricular myocardial strain (even with normal EF) and/or arrhythmias, as evidenced in the group studied, which is consistent with the previous international studies. Its complete cardiovascular evaluation is important to predict the risk of heart failure as part of a protocolized follow-up in well-established cardio oncology clinics.