Automatic border detection identifies subclinical anthracycline cardiotoxicity in children with malignancy

Area of Science:

• Cardiology
• Pediatric Oncology
• Medical Imaging

Background:

• Anthracycline chemotherapy can cause myocardial impairment in children, even at low doses.
• Early detection of cardiotoxicity is crucial for managing treatment and preventing long-term heart damage.

Purpose of the Study:

• To evaluate the clinical usefulness of automatic border detection (ABD) for identifying latent myocardial damage in asymptomatic children treated with anthracyclines.
• To assess if ABD can unmask subclinical anthracycline-induced cardiotoxicity.

Main Methods:

• Studied 34 children undergoing or having completed anthracycline chemotherapy (Chemo group) and 40 healthy children (Control group).
• All participants underwent comprehensive echocardiography, including M-mode, Doppler, and automatic border detection (ABD).
• Compared left ventricular function parameters between the groups using conventional echocardiography and ABD.

Main Results:

• Conventional echocardiography revealed no significant differences in ejection fraction or transmitral flow velocity between groups.
• Automatic border detection (ABD) showed significantly reduced peak filling rate (P<0.0001) and prolonged time to peak filling rate (P<0.0001) in the Chemo group compared to controls.
• These findings suggest subclinical myocardial damage in children treated with anthracyclines.

Conclusions:

• Echocardiographic ABD is a sensitive and valuable noninvasive tool for assessing subclinical anthracycline cardiotoxicity in children.
• ABD can detect early signs of heart damage missed by conventional echocardiographic methods.