Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors
Background Childhood cancer survivors (CCSs) show relevant cardiac morbidity and mortality throughout life. Early detection is key for optimal support of patients at risk. The aim of this study was to evaluate 2‐dimensional speckle‐tracking echocardiography strain analysis during semisupine exercise...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.025324 |
| _version_ | 1797936041817014272 |
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| author | Fabian von Scheidt Christine Pleyer Verena Kiesler Peter Bride Stephan Bartholomae Johannes Krämer Michael Kaestner Christian Apitz |
| author_facet | Fabian von Scheidt Christine Pleyer Verena Kiesler Peter Bride Stephan Bartholomae Johannes Krämer Michael Kaestner Christian Apitz |
| author_sort | Fabian von Scheidt |
| collection | DOAJ |
| description | Background Childhood cancer survivors (CCSs) show relevant cardiac morbidity and mortality throughout life. Early detection is key for optimal support of patients at risk. The aim of this study was to evaluate 2‐dimensional speckle‐tracking echocardiography strain analysis during semisupine exercise stress in CCSs for detection of subclinical left ventricular dysfunction after cancer treatment. Methods and Results Seventy‐seven CCSs ≥1‐year postchemotherapy were prospectively examined at rest, low, and submaximal stress level and compared with a cohort of healthy adolescents and young adults (n=50). Global longitudinal strain (GLS), short axis circumferential strain, and corresponding strain rates were analyzed using vendor‐independent software. CCSs at median 7.8 years postchemotherapy showed comparable left ventricular GLS, circumferential strain, and strain rate values at all stress stages to healthy controls. Yet, prevalence of abnormal GLS (defined as <2 SD of controls reference) in CCSs was 1.3% at rest, 2.7% at low, and 8.6% at submaximal stress. In CCSs, relative change of circumferential strain from rest to submaximal stress was lower than in healthy controls, median 16.9 (interquartile range [IQR], 3.4; 28.8) % versus 23.3 (IQR, 11.3; 33.3) %, P=0.03, most apparent in the subgroups of CCSs after high‐dose anthracycline treatment and cancer diagnosis before the age of 5 years. Conclusions In this prospective 2‐dimensional speckle tracking echocardiography strain study, prevalence of abnormal left ventricular GLS increased with stress level reflecting impaired cardiac adaptation to exercise stress in some CCSs. However, relatively early after last chemotherapy, this did not result in significant differences of mean GLS‐, circumferential strain‐, and strain rate values between CCSs and controls at any stress level. |
| first_indexed | 2024-04-10T18:24:34Z |
| format | Article |
| id | doaj.art-715aa7001c0c489088ef7b35b9dc1ce0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T18:24:34Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-715aa7001c0c489088ef7b35b9dc1ce02023-02-02T06:20:21ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111410.1161/JAHA.122.025324Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer SurvivorsFabian von Scheidt0Christine Pleyer1Verena Kiesler2Peter Bride3Stephan Bartholomae4Johannes Krämer5Michael Kaestner6Christian Apitz7Division of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Oncology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyDivision of Pediatric Cardiology, Children’s Hospital University of Ulm GermanyBackground Childhood cancer survivors (CCSs) show relevant cardiac morbidity and mortality throughout life. Early detection is key for optimal support of patients at risk. The aim of this study was to evaluate 2‐dimensional speckle‐tracking echocardiography strain analysis during semisupine exercise stress in CCSs for detection of subclinical left ventricular dysfunction after cancer treatment. Methods and Results Seventy‐seven CCSs ≥1‐year postchemotherapy were prospectively examined at rest, low, and submaximal stress level and compared with a cohort of healthy adolescents and young adults (n=50). Global longitudinal strain (GLS), short axis circumferential strain, and corresponding strain rates were analyzed using vendor‐independent software. CCSs at median 7.8 years postchemotherapy showed comparable left ventricular GLS, circumferential strain, and strain rate values at all stress stages to healthy controls. Yet, prevalence of abnormal GLS (defined as <2 SD of controls reference) in CCSs was 1.3% at rest, 2.7% at low, and 8.6% at submaximal stress. In CCSs, relative change of circumferential strain from rest to submaximal stress was lower than in healthy controls, median 16.9 (interquartile range [IQR], 3.4; 28.8) % versus 23.3 (IQR, 11.3; 33.3) %, P=0.03, most apparent in the subgroups of CCSs after high‐dose anthracycline treatment and cancer diagnosis before the age of 5 years. Conclusions In this prospective 2‐dimensional speckle tracking echocardiography strain study, prevalence of abnormal left ventricular GLS increased with stress level reflecting impaired cardiac adaptation to exercise stress in some CCSs. However, relatively early after last chemotherapy, this did not result in significant differences of mean GLS‐, circumferential strain‐, and strain rate values between CCSs and controls at any stress level.https://www.ahajournals.org/doi/10.1161/JAHA.122.0253242D‐speckle‐tracking strain echocardiographycardio‐oncologychildhood cancer survivorstress echocardiography |
| spellingShingle | Fabian von Scheidt Christine Pleyer Verena Kiesler Peter Bride Stephan Bartholomae Johannes Krämer Michael Kaestner Christian Apitz Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 2D‐speckle‐tracking strain echocardiography cardio‐oncology childhood cancer survivor stress echocardiography |
| title | Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors |
| title_full | Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors |
| title_fullStr | Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors |
| title_full_unstemmed | Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors |
| title_short | Left Ventricular Strain Analysis During Submaximal Semisupine Bicycle Exercise Stress Echocardiography in Childhood Cancer Survivors |
| title_sort | left ventricular strain analysis during submaximal semisupine bicycle exercise stress echocardiography in childhood cancer survivors |
| topic | 2D‐speckle‐tracking strain echocardiography cardio‐oncology childhood cancer survivor stress echocardiography |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.025324 |
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