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Published on: February 6, 2020
Diastolic function in anthracycline-treated children
Ashraf Harahsheh1, Sanjeev Aggarwal2, Michael D Pettersen3
11Department of Pediatrics,Division of Cardiology,Children's National Health System,The George Washington University School of Medicine,Washington,District of Columbia,United States of America.
Insights
Pediatric cancer patients treated with anthracyclines showed normal diastolic function 5 years post-therapy, assessed by Doppler echocardiography. Long-term monitoring is recommended to detect potential future cardiac changes.
Area of Science:
- Pediatric Cardiology
- Cardiotoxicity
- Cancer Therapeutics
Background:
- Anthracyclines are vital childhood cancer drugs but pose a risk of cardiomyopathy.
- Cardiac monitoring has primarily focused on systolic function, despite evidence of diastolic dysfunction in treated patients.
Purpose of the Study:
- To evaluate diastolic function in children 5 years after anthracycline therapy.
- Utilize transmitral inflow Doppler and tissue Doppler imaging for comprehensive diastolic assessment.
Main Methods:
- Retrospective analysis of 63 anthracycline-treated pediatric patients.
- Echocardiographic assessment included transmitral inflow (E, A, E/A, DT) and tissue Doppler (E', A', E/E', E'/A') parameters.
Main Results:
- All measured indices of diastolic function were normal in the study cohort.
- No significant diastolic dysfunction was detected 5 years post-anthracycline treatment.
Conclusions:
- Diastolic function remains normal 5 years after anthracycline therapy in children, based on Doppler echocardiography.
- Further longitudinal studies are necessary to ascertain the long-term evolution of diastolic function in this population.
Background:
Anthracyclines are effective medications for childhood cancer. Their limitation is the risk of cardiomyopathy. Although diastolic dysfunction has been described in patients who received anthracyclines, cardiac monitoring has focused on systolic function, which is abnormal in up to 41% of the patients. We conducted a study to assess diastolic function utilising transmitral inflow Doppler velocities and tissue Doppler imaging in anthracycline-treated children 5 years post-therapy.
Methods:
This was a retrospective study on 63 anthracycline-treated patients. Echocardiographic parameters included peak early and late transmitral inflow Doppler velocities (E, A), E/A ratio, E deceleration time, and tissue Doppler imaging early and late diastolic mitral annulus velocities (E', A'), E/E' ratio, and E'/A' ratio.
Results:
All indices of diastolic function that we measured were normal in the anthracycline-treated patients.
Conclusion:
We conclude that diastolic function assessed by transmitral inflow Doppler velocities and tissue Doppler imaging is normal in anthracycline-treated children 5 years after completion of treatment. Further longitudinal study is needed to determine whether diastolic function becomes abnormal with time in this patient population.
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