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Mitral regurgitation after anthracycline treatment for childhood malignancy

J Allen1, J D Thomson, I J Lewis

  • 1Department of Paediatric Cardiology, Yorkshire Heart Centre, E Floor, Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.

Heart (British Cardiac Society)
|March 17, 2001
PubMed

Insights

Anthracycline chemotherapy can cause new mitral regurgitation (MR) in children, detected by echocardiography. This early MR, along with ECG changes, may predict later heart damage (anthracycline cardiomyopathy).

Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Anthracyclines are widely used chemotherapy agents for childhood cancers.
  • Cardiotoxicity is a known side effect of anthracycline treatment.
  • Early detection of cardiac damage is crucial for managing treatment and improving outcomes.

Purpose of the Study:

  • To investigate the incidence of new-onset mitral regurgitation (MR) following anthracycline therapy in pediatric patients.
  • To assess the relationship between MR and other indicators of myocardial damage.
  • To determine if MR can serve as an early predictor of anthracycline-induced cardiomyopathy.

Main Methods:

  • Prospective echocardiographic and electrocardiographic study of 305 pediatric patients (aged 2-33 years) treated with anthracyclines.
  • Utilized color flow Doppler to detect MR and assessed left ventricular function indices.
  • Compared MR prevalence in treated patients to a normal control group.

Main Results:

  • 11.6% of patients developed ultrasound-detectable MR post-anthracycline treatment, significantly higher than the 1.8% in controls (p < 0.0001).
  • Nine patients also showed non-specific T wave abnormalities on ECG.
  • While initial systolic function was normal, four patients later developed impaired left ventricular function.

Conclusions:

  • New mitral regurgitation is significantly more prevalent in patients treated with anthracyclines.
  • Echocardiographic detection of MR, with or without ECG abnormalities, may be an early indicator of anthracycline cardiomyopathy.
  • This finding highlights the importance of cardiac monitoring in pediatric cancer survivors.
Abstract

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