Left ventricle segmental function in childhood cancer survivors using speckle-tracking echocardiography

Area of Science:

• Cardiology
• Pediatric Oncology
• Echocardiography

Background:

• Anthracycline chemotherapy is vital for treating childhood cancers but can cause cardiotoxicity.
• Cardiotoxicity may manifest as left ventricular abnormalities, potentially impacting long-term health in survivors.
• Early detection of subclinical cardiac changes is crucial for managing survivors.

Purpose of the Study:

• To assess left ventricular segmental function using 2D speckle-tracking echocardiography in asymptomatic childhood cancer survivors treated with anthracyclines.
• To identify potential early signs of cardiotoxicity beyond standard measures like ejection fraction.

Main Methods:

• Studied echocardiograms of childhood cancer survivors with normal left ventricular fractional shortening (>1 year post-anthracycline) and cancer-free controls.
• Analyzed peak systolic left ventricular longitudinal, radial, and circumferential strain in various apical and papillary muscle views.
• Compared strain parameters between survivor and control groups.

Main Results:

• Survivors exhibited significantly lower longitudinal strain in two-, three-, and four-chamber views compared to controls.
• Global longitudinal and circumferential strain were reduced in childhood cancer survivors.
• 12 out of 16 left ventricular segments showed significantly lower longitudinal strain in survivors.

Conclusions:

• Asymptomatic survivors treated with anthracyclines demonstrate reduced global longitudinal and circumferential strain.
• The findings suggest anthracycline cardiotoxicity is predominantly global rather than regional.
• Early detection of strain abnormalities may aid in monitoring and managing cardiotoxicity in these patients.