Tissue Doppler imaging in detection of myocardial dysfunction in survivors of childhood cancer treated with anthracyclines

Objective: To determine the utility of tissue Doppler imaging (TDI) in detecting early right ventricle (RV) myocardial dysfunction, given its prognostic implications in patients with chronic obstructive pulmonary disease (COPD).Methods: A prospective case-control study was carried out involving 36 COPD patients in an acute exacerbated state as cases and 34 healthy subjects serving as controls. Each subject underwent a baseline echocardiography using various methods ranging from m-mode and 2-dimensional measures for analyzing RV geometry to strain and strain rate using Tissue Doppler Imaging to measure RV deformation. The cases underwent a subsequent echocardiogram 1month later once the respiratory symptoms subsided.Results: A significant difference was observed in RV tissue annular velocities ( E’, A’, S) between cases and the controls at baseline. However no significant increase was observed in tissue annular velocities among cases during remission states from baseline. Peak systolic strain in COPD group was significantly reduced in comparison to controls, but not significantly increased during remission when compared to baseline in cases. FEV1/VC did not bear any significant correlation with RV strain. Tei index had a negative linear correlation with peak systolic strain of RV, which was statistically significant.Conclusion: TDI parameters revealed that RV dysfunction remains unaltered even in remission state of COPD, despite pulmonary arterial pressure normalizing. In light of it bearing a negative prognosis in COPD, RV dysfunction merits assessment in COPD patients, both in acute exacerbations as well as in remission.

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Evaluation of long-term cardiac side effects of anthracycline chemotherapy by conventional and non-conventional echocardiographic methods in childhood cancer survivors

Cardiology in the Young ◽

10.1017/s1047951119001094 ◽

2019 ◽

Vol 29 (7) ◽

pp. 904-909 ◽

Cited By ~ 3

Author(s):

Tamer Yoldaş ◽

Şule Yeşil ◽

Selmin Karademir ◽

Gürses Şahin ◽

Utku Arman Örün ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Tissue Doppler Imaging ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Childhood Cancer Survivors ◽

Tissue Doppler ◽

Doppler Imaging ◽

Control Group

AbstractObjective:Anthracycline chemotherapeutic agents carry the well-recognised risk of cardiac toxicity. The aim of this study was to determine the long-term effect of anthracycline chemotherapy on the biventricular function in childhood cancer survivors using tissue Doppler imaging and two-dimensional speckle tracking echocardiography.Patients and Methods:The study included 45 survivors of childhood cancers and 50 healthy age-matched control patients. Cardiac function was prospectively studied with conventional echocardiography, tissue Doppler imaging, and speckle tracking echocardiography after completion of treatment. The same analysis was performed on matched controls.Results:There was no difference in age, gender, height, and weight between the study and control groups. The mean anthracycline dose was 240 ± 106 mg/m2 and the mean remission duration was 8.2 ± 5 years (1–20 years) in the study group. Conventional echocardiography showed similar ejection fraction, shortening fraction, and left ventricle end-diastolic diameter in both groups. Mitral lateral and septal tissue Doppler imaging showed normal but according to control group relatively sub-normal systolic and diastolic function in patient group. The global longitudinal and circumferential strain and strain rates were significantly lower in the patient group compared to control group. Correlation analysis revealed a negative and significant correlation between total anthracycline dose and global longitudinal and circumferential strain and strain rates.Conclusion:Sub-clinical systolic and diastolic dysfunction may not be detected by conventional echocardiographic methods which are frequently used in daily practice. Sub-clinical systolic and diastolic dysfunction may be detected more sensitively by echocardiographic method such as speckle tracking echocardiography in childhood cancer survivors.

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