Extensive Cardiac Function Analyses Using Contemporary Echocardiography in Childhood Cancer Survivors

• DOI: 10.1016/j.jaccao.2023.06.003
• Publication Date: 2023-08-15T18:03:53Z
• Authors: Remy Merkx; Jan M. Leerink; E. (Lieke) A.M. F...; Esmée C. de Baat; Louise Bellersen; Dorine Bresters; Elvira C. van Dalen; Eline van Dulmen-...; Margriet van der ...; Marry M. van den ...; Judith L. Kok; Marloes Louwerens; Angela H.E.M. Maas; Sebastian J.C.M.M...; Cécile M. Ronckers; Jop C. Teepen; Arco J. Teske; Wim J.E. Tissing; Andrica C.H. de V...; Gert Weijers; Chris L. de Korte; Jacqueline Loonen; Annelies M.C. Mav...; Helena J.H. van d...; Leontien C.M. Kremer; Wouter E.M. Kok; Livia Kapusta
• Keywords: Cardiotoxicity; Mitoxantrone; Epirubicin

Childhood cancer survivors (CCS) are at risk for cardiotoxicity.We sought to assess how cardiac dysfunction measurements in CCS overlap and differentially influenced by factors.This cross-sectional Dutch Cancer Survivor Study evaluated echocardiograms of 1,397 ≥5-year 277 siblings. Of CCS, n = 1,254 received cardiotoxic (anthracyclines/mitoxantrone/radiotherapy involving the heart region [RTheart]) 143 potentially (cyclophosphamide, ifosfamide, or vincristine) therapy. We assessed demographic, treatment-related, traditional cardiovascular factors using multivariable logistic regression.CCS were a median 26.7 years after diagnosis; 49% women. Abnormal left ventricular ejection fraction (LVEF) (defined as <52% men, <54% women) occurred most commonly treated with anthracyclines RTheart combined (38%). Age/sex-specific abnormal global longitudinal strain (GLS) RTheart, either (41%) without (38%) anthracyclines. normal LVEF, 20.2% showed GLS. Diastolic grade ≥II was rare. LVEF mainly associated female sex, anthracycline dose, only women, dose. GLS diastolic blood pressure, Cyclophosphamide, vincristine not Compared siblings, higher (OR: 2.9; 95% CI: 1.4-6.6) 2.1; 1.2-3.7), independent (potentially) treatment-related factors.Abnormal constitute complementary measures systolic among long-term CCS. Their diagnostic value may differ according exposures. Also, have residual, unexplained dysfunction. (Early Detection Cardiac Dysfunction Survivors, DCOG LATER study; NTR7481).