Left ventricular myocardial deformation and mechanical dyssynchrony in children with normal ventricular shortening fraction after anthracycline therapy

Abstract

Impaired left ventricular myocardial deformation and mechanical dyssynchrony may exist in children after anthracycline therapy despite having normal left ventricular shortening fractions.

Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography

“…In our study, the RS, as well as LS and CS showed significant reduction after chemotherapy, which was in concordance with some previous studies [12,16], however, discordant with others [11,17]. Ho et al [11] demonstrated that there was no significant difference in RS between the chemotherapy and control groups.…”

“…With the advantages of angle independence, speckle tracking echocardiography, allowing comprehensive assessment of both regional and global LV myocardial deformation, may provide reliable and sensitive parameter for early cardiotoxicity detection. In a cross-sectional study, Ho et al [11] found that compared with normal volunteers, subclinical systolic myocardial abnormalities were present in asymptomatic breast cancer survivors up to 6 years after anthracycline treatment using speckle tracking echocardiography, which was proved by other speckle tracking echocardiography-derived study [12]. However, there was a limited study demonstrating early subclinical cardiotoxicity in patients receiving anthracycline.…”

“…Cheung et al [12] proved that dyssynchronous LV contraction was documented using real-time 3D echocardiography in children after anthracycline therapy. However, in our study, we found no significant difference shortly after epirubicin administration evaluated by T LS-SD , T CS-SD and T RS-SD in adult patients.…”

Effect of myocardial dysfunction in cardiac morbidity and all cause mortality in childhood cancer subjects treated with anthracycline therapy

“…The period of subclinical cardiotoxicity is characterized by structural and functional myocardial abnormalities and is highly prevalent amongst asymptomatic pediatric cancer survivors [21,[24][25][26][27][28]. Treatment of subclinical dysfunction with Enalapril and possibly Carvedilol may help prevent or decrease the incidence of cardiac events if started earlier after chemotherapy [29,30] and in addition may decrease cancer progression and cancer specific mortality in some patients [31].…”

Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

“…Finally, four studies evaluated the deformation parameters in long-term cancer survivors (range, 2-30 years after treatment). 150,154,163,164 In two of the studies with longer follow-up and/ or higher doses of anthracyclines, the LVEF (or fractional shortening) was slightly decreased. 163,164 In contrast, all four studies detected decreases in longitudinal and radial (and circumferential when studied) parameters compared with age-matched control patients, underlining the sensitivity of these parameters in the detection of sub-clinical LV dysfunction.…”