Cardiovascular Evaluation of Children With Malignancies

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Anthracyclines (AC) are vital chemotherapy agents for childhood cancers.
• Cardiovascular complications are a significant cause of morbidity and mortality in AC recipients.
• Higher cumulative AC dosage is the primary risk factor for cardiotoxicity.

Purpose of the Study:

• To review the causes and risk factors of anthracycline-induced cardiotoxicity.
• To highlight non-invasive imaging modalities for surveillance.
• To discuss prevention and treatment guidelines.

Main Methods:

• Review of current literature on anthracycline-induced cardiotoxicity.
• Emphasis on non-invasive cardiac imaging techniques.
• Analysis of surveillance and management guidelines.

Main Results:

• Two-dimensional echocardiography (ejection fraction, shortening fraction) is standard for monitoring cardiac function.
• Speckle tracking echocardiography shows promise in detecting early ventricular dysfunction.
• Three-dimensional echocardiography offers more accurate ejection fraction estimation.
• Cardiac MRI techniques (delayed enhancement, T1 mapping) assist in evaluating patients with poor echocardiographic windows.

Conclusions:

• Early detection and management of cardiovascular disease are crucial for childhood cancer survivors.
• Incorporating advanced echocardiography (speckle tracking, 3D) can identify early anthracycline-induced cardiotoxicity.
• Further research is needed to guide management based on speckle tracking echocardiography findings.