Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening
Background: The majority of childhood cancer survivors (CCSs) have been exposed to cardiotoxic treatments and often present with modifiable cardiovascular risk factors. Our aim was to evaluate the value of left ventricular (LV) longitudinal strain for increasing the sensitivity of cardiac dysfunctio...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.715953/full |
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| author | Jussi Niemelä Jussi Niemelä Kaisa Ylänen Kaisa Ylänen Kaisa Ylänen Anu Suominen Kuberan Pushparajah Kuberan Pushparajah Sujeev Mathur Sujeev Mathur Taisto Sarkola Taisto Sarkola Kirsi Jahnukainen Anneli Eerola Anneli Eerola Tuija Poutanen Tuija Poutanen Kim Vettenranta Tiina Ojala |
| author_facet | Jussi Niemelä Jussi Niemelä Kaisa Ylänen Kaisa Ylänen Kaisa Ylänen Anu Suominen Kuberan Pushparajah Kuberan Pushparajah Sujeev Mathur Sujeev Mathur Taisto Sarkola Taisto Sarkola Kirsi Jahnukainen Anneli Eerola Anneli Eerola Tuija Poutanen Tuija Poutanen Kim Vettenranta Tiina Ojala |
| author_sort | Jussi Niemelä |
| collection | DOAJ |
| description | Background: The majority of childhood cancer survivors (CCSs) have been exposed to cardiotoxic treatments and often present with modifiable cardiovascular risk factors. Our aim was to evaluate the value of left ventricular (LV) longitudinal strain for increasing the sensitivity of cardiac dysfunction detection among CCSs.Methods: We combined two national cohorts: neuroblastoma and other childhood cancer survivors treated with anthracyclines. The final data consisted of 90 long-term CCSs exposed to anthracyclines and/or high-dose chemotherapy with autologous stem cell rescue and followed up for > 5 years and their controls (n = 86). LV longitudinal strain was assessed with speckle tracking (Qlab) and LV ejection fraction (EF) by three-dimensional echocardiography (3DE).Results: Of the CCSs, 11% (10/90) had abnormal LV longitudinal strain (i.e., < -17.5%); of those, 70% (7/10) had normal 3DE LV EF. Multivariable linear model analysis demonstrated that follow-up time (p = 0.027), sex (p = 0.020), and BMI (p = 0.002) were significantly associated with LV longitudinal strain. Conversely, cardiac risk group, hypertension, age, cumulative anthracycline dose or exposure to chest radiation were not.Conclusion: LV longitudinal strain is a more sensitive method than LV EF for the detection of cardiac dysfunction among CCSs. Therefore, LV longitudinal strain should be added to the screening panel, especially for those with modifiable cardiovascular risk factors. |
| first_indexed | 2024-12-22T14:54:08Z |
| format | Article |
| id | doaj.art-e4e5e00a08854668a22cbc398624ab76 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-22T14:54:08Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-e4e5e00a08854668a22cbc398624ab762022-12-21T18:22:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.715953715953Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in ScreeningJussi Niemelä0Jussi Niemelä1Kaisa Ylänen2Kaisa Ylänen3Kaisa Ylänen4Anu Suominen5Kuberan Pushparajah6Kuberan Pushparajah7Sujeev Mathur8Sujeev Mathur9Taisto Sarkola10Taisto Sarkola11Kirsi Jahnukainen12Anneli Eerola13Anneli Eerola14Tuija Poutanen15Tuija Poutanen16Kim Vettenranta17Tiina Ojala18Department of Pediatric Cardiology, Pediatric Research Center, New Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandDepartment of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, FinlandDepartment of Pediatric Cardiology, Pediatric Research Center, New Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandCenter for Child Health Research, Tampere, FinlandDepartment of Pediatrics, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, FinlandDivision of Hematology-Oncology and Stem Cell Transplantation, New Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandDepartment of Paediatric Cardiology, Evelina London Children's Hospital, Guy's & St. Thomas' NHS Trust, London, United KingdomSchool of Biomedical Engineering and Imaging Sciences, King's College London, London, United KingdomDepartment of Paediatric Cardiology, Evelina London Children's Hospital, Guy's & St. Thomas' NHS Trust, London, United KingdomSchool of Biomedical Engineering and Imaging Sciences, King's College London, London, United KingdomDepartment of Pediatric Cardiology, Pediatric Research Center, New Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical Research, Biomedicum Helsinki, Helsinki, FinlandDivision of Hematology-Oncology and Stem Cell Transplantation, New Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandCenter for Child Health Research, Tampere, FinlandDepartment of Pediatrics, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, FinlandCenter for Child Health Research, Tampere, FinlandDepartment of Pediatrics, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, FinlandDepartment of Pediatrics, New Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandDepartment of Pediatric Cardiology, Pediatric Research Center, New Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, FinlandBackground: The majority of childhood cancer survivors (CCSs) have been exposed to cardiotoxic treatments and often present with modifiable cardiovascular risk factors. Our aim was to evaluate the value of left ventricular (LV) longitudinal strain for increasing the sensitivity of cardiac dysfunction detection among CCSs.Methods: We combined two national cohorts: neuroblastoma and other childhood cancer survivors treated with anthracyclines. The final data consisted of 90 long-term CCSs exposed to anthracyclines and/or high-dose chemotherapy with autologous stem cell rescue and followed up for > 5 years and their controls (n = 86). LV longitudinal strain was assessed with speckle tracking (Qlab) and LV ejection fraction (EF) by three-dimensional echocardiography (3DE).Results: Of the CCSs, 11% (10/90) had abnormal LV longitudinal strain (i.e., < -17.5%); of those, 70% (7/10) had normal 3DE LV EF. Multivariable linear model analysis demonstrated that follow-up time (p = 0.027), sex (p = 0.020), and BMI (p = 0.002) were significantly associated with LV longitudinal strain. Conversely, cardiac risk group, hypertension, age, cumulative anthracycline dose or exposure to chest radiation were not.Conclusion: LV longitudinal strain is a more sensitive method than LV EF for the detection of cardiac dysfunction among CCSs. Therefore, LV longitudinal strain should be added to the screening panel, especially for those with modifiable cardiovascular risk factors.https://www.frontiersin.org/articles/10.3389/fcvm.2021.715953/fullcardiotoxicitychildhood cancerlongitudinal strainspeckle trackingcardiovascular risk (CV risk) |
| spellingShingle | Jussi Niemelä Jussi Niemelä Kaisa Ylänen Kaisa Ylänen Kaisa Ylänen Anu Suominen Kuberan Pushparajah Kuberan Pushparajah Sujeev Mathur Sujeev Mathur Taisto Sarkola Taisto Sarkola Kirsi Jahnukainen Anneli Eerola Anneli Eerola Tuija Poutanen Tuija Poutanen Kim Vettenranta Tiina Ojala Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening Frontiers in Cardiovascular Medicine cardiotoxicity childhood cancer longitudinal strain speckle tracking cardiovascular risk (CV risk) |
| title | Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening |
| title_full | Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening |
| title_fullStr | Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening |
| title_full_unstemmed | Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening |
| title_short | Cardiac Function After Cardiotoxic Treatments for Childhood Cancer—Left Ventricular Longitudinal Strain in Screening |
| title_sort | cardiac function after cardiotoxic treatments for childhood cancer left ventricular longitudinal strain in screening |
| topic | cardiotoxicity childhood cancer longitudinal strain speckle tracking cardiovascular risk (CV risk) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.715953/full |
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