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Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
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Early Ventricular Dysfunction After Anthracycline Chemotherapy in Children
Hala Agha1, Lobna Shalaby2, Wael Attia3
1Pediatric Cardiology Division, Department of Pediatrics, Specialized Pediatric Hospital, Faculty of Medicine, Cairo University, Kasr Al Aini street, Cairo, 11562, Egypt. halaazza@gmail.com.
Pediatric Cardiology
|December 16, 2015
Summary
Anthracycline chemotherapy impacts biventricular cardiac function in children with acute hematological malignancies. Tissue Doppler imaging (TDI) and 2D speckle tracking echocardiography (2D-STE) reveal early diastolic dysfunction in the right ventricle and longitudinal systolic impairment in the left ventricle.
Area of Science:
- Cardiology
- Pediatric Oncology
- Medical Imaging
Background:
- Anthracycline chemotherapy is a cornerstone in treating acute hematological malignancies (AHM) in children.
- Cardiotoxicity is a significant concern, necessitating early detection and monitoring of cardiac function.
Purpose of the Study:
- To evaluate the effect of induction chemotherapy dose on biventricular function in pediatric patients with AHM.
- To assess the utility of tissue Doppler imaging (TDI) and 2D speckle tracking echocardiography (2D-STE) in detecting early cardiotoxicity.
Main Methods:
- Conventional echocardiography, TDI, and 2D-STE were performed on 30 pediatric patients with AHM before and after induction chemotherapy.
- Analysis focused on parameters of right ventricular (RV) and left ventricular (LV) diastolic and systolic function.
Main Results:
- Post-chemotherapy, RV showed diastolic dysfunction (reduced E', E'/A' ratio; increased MPI, isovolumetric relaxation time).
- LV exhibited longitudinal systolic impairment (reduced MAPSE, lateral mitral annular systolic velocity, global longitudinal strain, and strain rate).
- LV diastolic function remained preserved compared to baseline.
Conclusions:
- TDI and 2D-STE are effective tools for early detection of anthracycline-induced cardiotoxicity in pediatric patients.
- Early induction chemotherapy primarily induces RV diastolic dysfunction and LV longitudinal systolic impairment.
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