Subclinical Cardiac Dysfunction in Childhood Cancer Survivors: Insights from Global Longitudinal Strain and Risk...

Area of Science:

• Cardiology
• Pediatric Oncology
• Cardiovascular Research

Background:

• Childhood cancer survivors (CCS) face increased long-term cardiovascular risks.
• Subclinical cardiac dysfunction may precede overt heart failure in these patients.
• Early detection is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To assess subclinical cardiac dysfunction in asymptomatic CCS.
• To investigate the association between cardiac dysfunction and cancer treatment exposures.
• To identify metabolic risk factors contributing to cardiac dysfunction in CCS.

Main Methods:

• Cross-sectional, observational study of pediatric and young adult CCS.
• Cardiovascular evaluation including 2D-echocardiography with global longitudinal strain (GLS) analysis.
• Data collection on cancer history, cumulative anthracycline-equivalent doses (CAE), and cardiac radiation.

Main Results:

• Abnormal GLS detected in 41.4% of 456 asymptomatic CCS.
• Increased GLS abnormalities associated with CAE dose > 250 mg/m² (P=0.012).
• Obesity (P=0.004) and hypertriglyceridemia (P=0.05) were also linked to abnormal GLS.

Conclusions:

• Subclinical cardiac dysfunction is prevalent in asymptomatic CCS.
• Higher anthracycline exposure, obesity, and dyslipidemia are associated with cardiac dysfunction.
• Routine cardiac surveillance with strain imaging and risk factor management are recommended for CCS.