Left Ventricular Longitudinal Strain Abnormalities in Childhood Exposure to Anthracycline Chemotherapy.
Arnaud RiqueJennifer CautelaYuichi TamuraGérard MichelCaroline OvaertCaroline OvaertPublished in: Children (Basel, Switzerland) (2024)
Current mortality is low in cases of childhood acute leukemia. Dilated cardiomyopathy induced by anthracyclines remains the main cause of morbidity and mortality during mid-term and long-term follow-up. The aim of our study was to analyze the profile of left ventricular alterations in children treated with anthracyclines and to analyze risks and protective factors, including physical activity. Children and young adults with acute leukemia treated with anthracyclines between 2000 and 2018 during childhood were included. The physical activity performed by the patients before and after treatment was quantified in metabolic equivalent tasks, MET.h, per week. An echocardiographic assessment was performed, including strain analysis. Thirty-eight patients with a median age of 5 [3-8] years were included. Dilated cardiomyopathy was diagnosed in 3 patients and longitudinal strain abnormalities were observed in 11 patients (28.9%). Radiotherapy, cumulative anthracycline doses > 240 mg/m 2 , and the practice of physical activity > 14 MET.h per week (after leukemia treatment) were independently associated with strain abnormalities. In multivariate analysis, radiotherapy was significantly associated with an increased risk of LV GLS abnormalities (OR = 1.26 [1.01-1.57], p = 0.036), and physical activity > 14 MET.h/week after oncological treatment was significantly associated with a reduction in the risk of LV GLS abnormalities (OR of 0.03 [0.002-0.411], p = 0.009). The strain assessment of left ventricular function is an interesting tool for patient follow-up after leukemia treatment. Moderate and steady physical activity seems to be associated with fewer longitudinal strain abnormalities in patients treated with anthracyclines during childhood.
Keyphrases
- physical activity
- left ventricular
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- heart failure
- body mass index
- aortic stenosis
- healthcare
- early stage
- prognostic factors
- young adults
- prostate cancer
- radiation therapy
- acute myocardial infarction
- mitral valve
- hypertrophic cardiomyopathy
- squamous cell carcinoma
- acute myeloid leukemia
- clinical trial
- patient reported outcomes
- locally advanced
- cross sectional
- randomized controlled trial
- study protocol
- pulmonary hypertension
- cardiovascular disease
- risk factors
- cardiovascular events
- sleep quality
- cardiac resynchronization therapy
- middle aged
- double blind