Akademik Veri Yönetim Sistemi
Turkish Archives of Pediatrics, cilt.56, sa.5, ss.492-498, 2021 (ESCI)
Background: Childhood cancer survivors (CCSs) are at risk for anthracycline-induced cardiotoxicity which tends to be more prominent long after completion of the chemotherapy. The aim
of this study was to examine echocardiographic parameters of anthracycline-induced subclinical cardiotoxicity in children who had received chemotherapy.
Materials and Methods: A cross-sectional single-center study was conducted in a tertiary level
university hospital in Eskisehir, Turkey. A total of 50 CCSs and 40 healthy peers were included. The
CCSs were divided into 3 subgroups according to cumulative anthracycline dose (100-200 mg/m2
,
201-299 mg/m2
, and ≥ 300 mg/m2
). Biventricular cardiac examination was performed with conventional echocardiography and tissue Doppler echocardiography imaging (TDI).
Results: The mean duration from termination of chemotherapy to echocardiographic assessment was 3.9 ± 2.2 years. The mean age of the CCSs was 11.6 ± 3.9 years. TDI-derived mitral
annular isovolumetric relaxation time (IVRT) and myocardial performance index (MPI)
were higher in the high-dose group of CCSs than in controls (P = .006, P = .007, P < .001, P
= .0014, respectively). IVRT was also higher in patients with ≥ 300 mg/m2
cumulative dose
than in those with < 200 mg/m2
(P = .007). TDI-derived mitral annular MPI and IVRT were
significantly associated with cumulative anthracycline dose (r = 0.288, P = .006, r = 0.340,
P = .001).
Conclusion: A cumulative anthracycline dose > 300 mg/m2
may lead to subclinical cardiotoxicity, and is therefore a potential risk factor for late onset cardiac failure. TDI-derived MPI can be
a sensitive tool to reveal subtle signs of myocardial damage, which may facilitate implementation of preventive therapies for patients suspected to be at risk.