+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Noninvasive evaluation of late anthracycline cardiac toxicity in childhood cancer survivors



Noninvasive evaluation of late anthracycline cardiac toxicity in childhood cancer survivors



Journal of Clinical Oncology 25(24): 3635-3643



PURPOSEl: Childhood cancer survivors treated with anthracyclines and cardiac radiation are at risk for late-onset cardiotoxicity. The purpose of this study was to delineate the relationship between clinical factors and abnormalities of noninvasive cardiac testing (NICT). Participants were recruited from a long-term follow-up clinic. Study measures comprised physical examination, laboratory evaluation, echocardiogram, and ECG. Mean fractional shortening (FS) and afterload were compared for survivors who did (at risk [AR]) and did not (no risk [NR]) receive potentially cardiotoxic modalities, and with values expected for comparable age- and sex-matched controls. The 278 study participants (mean age, 18.1 years; median age, 16.8 years; range, 7.5 to 39.7 years) included 223 survivors AR for cardiotoxicity after treatment with anthracyclines (median dose +/- standard deviation [SD], 202 +/- 109 mg/m(2)) and/or cardiac radiation. Mean FS (+/- SD) was lower for AR (0.33 +/- 0.06) compared with NR survivors (0.36 +/- 0.05; P = .004) and normative controls (0.36 +/- 0.04; P < .001). Mean afterload (+/- SD) was higher for AR (58 +/- 21 g/cm(2)) compared with NR survivors (46 +/- 15 g/cm(2); P < .001) and normative controls (48 +/- 13 g/cm(2); P < .001). The distribution of FS and afterload among NR survivors did not differ from that of controls. After adjustment for age group at diagnosis and time since completion of therapy, anthracycline dose predicted decline in distribution of FS (P < .001) and increase in distribution of afterload (P < .001). Treatment with anthracycline doses >or= 100 mg/m(2) increased the risk of abnormal NICT; survivors who received >or= 270 mg/m(2) had a 4.5-fold excess risk of abnormal NICT (95% CI, 2.1 to 9.6) compared with controls. Childhood cancer survivors treated with anthracycline doses >or= 270 mg/m(2) are at greatest risk for abnormalities of FS and afterload.

(PDF emailed within 0-6 h: $19.90)

Accession: 054648294

Download citation: RISBibTeXText

PMID: 17704413

DOI: 10.1200/JCO.2006.09.7451


Related references

Anthracycline-induced cardiac toxicity more likely in underweight childhood cancer survivors. Journal of Pediatric Hematology/Oncology 32(5): 411-415, 2010

Evaluation of late cardiac toxicity of anthracycline in childhood. Minerva Pediatrica 50(4): 111-119, 1998

Dobutamine stress echocardiography in the evaluation of late anthracycline cardiotoxicity in childhood cancer survivors. Pediatric Research 39(3): 504-512, 1996

Evaluation of traditional and novel measures of cardiac function to detect anthracycline-induced cardiotoxicity in survivors of childhood cancer. Journal of Cancer Survivorship 8(2): 183-189, 2015

Cranial irradiation as an additional risk factor for anthracycline cardiotoxicity in childhood cancer survivors: an analysis from the cardiac risk factors in childhood cancer survivors study. Pediatric Cardiology 34(4): 826-834, 2013

Evaluation of cardiac reserved function by high-dose dobutamine-stress echocardiography in asymptomatic anthracycline-treated survivors of childhood cancer. Pediatrics International 48(3): 313-320, 2006

Low-dose dobutamine echo stress test for the evaluation of cardiac function in asymptomatic childhood cancer survivors treated years before with anthracycline. European Heart Journal 19(ABST SUPPL ): 312, 1998

Subclinical late cardiac toxicity in childhood cancer survivors: impact on self-reported health. Cancer 112(8): 1835-1844, 2008

Are cardiac magnetic resonance imaging and radionuclide ventriculography good options against echocardiography for evaluation of anthracycline induced chronic cardiotoxicity in childhood cancer survivors?. Pediatric Hematology and Oncology 31(3): 237-252, 2015

Screening for cardiac dysfunction in anthracycline-exposed childhood cancer survivors. Clinical Cancer Research 20(24): 6314-6323, 2015

Screening for Anthracycline-Related Cardiac Dysfunction in Childhood Cancer Survivors: Can Less be More?. Pediatric Blood & Cancer 62(12): 2067-2068, 2016

Echocardiographic surveillance for asymptomatic late-onset anthracycline cardiomyopathy in childhood cancer survivors. Pediatric Blood & Cancer 57(3): 467-472, 2011

Treatment for asymptomatic anthracycline-induced cardiac dysfunction in childhood cancer survivors: the need for evidence. Journal of Clinical Oncology 21(17): 3377; Author Reply 3377-8, 2003

LV structure, LV function, and serum NT-proBNP in childhood cancer survivors without anthracycline or cardiac radiation exposures. Progress in Pediatric Cardiology 31(2): 141-142, 2011

Cardiac magnetic resonance imaging in the evaluation of the late effects of anthracyclines among long-term survivors of childhood cancer. Journal of the American College of Cardiology 61(14): 1539-1547, 2013