Cardiac status in bone tumor survivors up to nearly 19 years after treatment with doxorubicin: A longitudinal study

Postma, A.; Elzenga, Nynke J.; Haaksma, J.; Leeuwen, M. J. M. Schasfoort-van; Kamps, Willem A.; Bink‐Boelkens, Margreet Th.E.

doi:10.1002/mpo.10074

Cited by 30 publications

(13 citation statements)

References 36 publications

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“…For example, the HRV parameters among our premature infants were all somewhat lower than those reported by those evaluating HRV in term infants (50,51), consistent with reports that HRV parameters are lower among infants of lower postconceptional age (21,22,25,36,50,(52)(53)(54). Likewise, our results for the values of HRV parameters in pediatric oncology patients are similar to those found in earlier studies (13); values for HRV parameters in oncology patients may be lower than healthy children of similar ages due to cardiac toxicity of anthracycline chemotherapy, pain or other symptoms (55).…”

Section: Hrv Outlier Methodssupporting

confidence: 78%

Heart Rate Variability: Impact of Differences in Outlier Identification and Management Strategies on Common Measures in Three Clinical Populations

2007

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Heart rate variability (HRV) is reported increasingly in pediatric research, but different strategies used to identify and manage potential outlier beats impact HRV parameter values in adults and animals. Do they in pediatrics? To compare the impact of different strategies to identifying and managing outliers, we used interbeat interval (IBI) data from three different populations: 10 stable premature infants, 33 stable pediatric oncology patients, and 15 healthy adults. Five commonly reported HRV parameters were compared using three identification and two management strategies to filter potential outliers. The three populations had different resting heart rates: 155 Ϯ 9 beats per minute (bpm) in infants, 105 Ϯ 17 bpm in children, and 87 Ϯ 12 bpm in adults. All three identification strategies flagged fewer than 2% of IBIs; the threshold identification strategy, excluding IBIs denoting heart rates Ͻ30 or Ͼ300 bpm, identified significantly fewer outliers than the other two strategies and generated higher HRV parameters in all populations (p Ͻ 0.001). There were no significant differences in HRV parameters calculated by managing identified outliers by "tossing" them versus "interpolating" values. Different strategies for identifying potential outliers are associated with significant differences in HRV parameters. Pediatric researchers who report HRV should detail their outlier filtering strategies. (Pediatr Res 62: 337-342, 2007) H eart rate variability (HRV) measurements are increasingly used by researchers to describe physiology, provide prognostic information, and measure response to therapies (1). HRV is the beat-to-beat variation of the interbeat interval (IBI) of the ECG (ECG). This variability is modulated primarily by the sympathetic and parasympathetic autonomic nervous system (2-4). Methods for calculating time and frequency-domain parameters of HRV were recommended by the Task Force of the European Society of Cardiology (5) and these methods have been widely adopted (6).The SD of the IBI (SDNN) is the most widely used measure of HRV, followed by the root mean square of the difference of successive IBIs (RMSSD). Other commonly used parameters include pNN50 (the percentage of IBIs that differ by more than 50 ms from the previous IBI), and parameters from power spectral analyses based on fast Fourier transformations, particularly low frequency (LF) and high frequency (HF) power. HF oscillations (0.15-0.4 Hz) are thought to be markers of parasympathetic and particularly vagal autonomic tone. LF oscillations (0.04 -0.15 Hz) reflect sympathetic and to a lesser extent, parasympathetic tone (7).Increases in HRV parameters, up to a point, reflect adaptability, resilience and well being, while decreases in HRV reflect rigidity, poor health status and a poor prognosis in both adults and children with a wide variety of clinical conditions (8 -23). In children HRV generally increases between the birth and fourteen years of age as the autonomic nervous system matures (24,25). In adults HRV generally decreases...

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Section: Hrv Outlier Methodssupporting

confidence: 78%

Heart Rate Variability: Impact of Differences in Outlier Identification and Management Strategies on Common Measures in Three Clinical Populations

2007

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“…Although some have reported occasional instances of sudden death 177 that may be related to repolarization abnormalities (QT prolongation and abnormal QT dispersion) in association with ventricular dysfunction, 455 others have described only infrequent and clinically unimportant arrhythmias. 456 Other studies of pediatric cancer survivors have described ventricular arrhythmias in association with late ventricular dysfunction, 457 but in general, these studies have been small and were not systematic evaluations of the population at risk. There are no data about whether the risk of arrhythmia exceeds that found in other causes of ventricular dysfunction.…”

Section: Screening For Arrhythmias and Conduction Defectsmentioning

confidence: 99%

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Lipshultz¹,

Adams²,

Colan³

et al. 2013

Circulation

504

436

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“…There is an increase in ventricular ectopy in patients receiving doxorubicin during the acute infusion period, but this is very rarely of any significance (1067,1068). Some studies have suggested reduced HRV, abnormalities in area ratios on SAECG, and increased QTc may be indicators of impending cardiomyopathy and electrical instability, but these have yet to be substantiated (1066,1069,1070). Long-term intermittent cardiac assessment of patients is therefore necessary and cardiac decompensation should be treated conventionally.…”

Section: Sudden Cardiac Death and Psychiatric Or Neurological Diseasementioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Zipes¹,

Camm²,

Borggrefe³

et al. 2006

Circulation

1,206

671

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Cardiac status in bone tumor survivors up to nearly 19 years after treatment with doxorubicin: A longitudinal study

Cited by 30 publications

References 36 publications

Heart Rate Variability: Impact of Differences in Outlier Identification and Management Strategies on Common Measures in Three Clinical Populations

Heart Rate Variability: Impact of Differences in Outlier Identification and Management Strategies on Common Measures in Three Clinical Populations

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

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