Cor Vasa 2008, 50(10):378-384 | DOI: 10.33678/cor.2008.136

Evaluation of left ventricular function in patients treated for malignancy in childhood

Pavla Balcárková^1,*, Lubomír Elbl², Zuzana Nováková³, Hana Hrstková⁴, Jiří Vítovec¹, Jana Šťastná⁴, Klára Krontorádová⁴

¹ I. interní kardioangiologická klinika, Fakultní nemocnice u sv. Anny a Lékařská fakulta Masarykovy univerzity

² Interní hematoonkologická klinika, Fakultní nemocnice Brno a Lékařská fakulta Masarykovy univerzity

³ Fyziologický ústav, Lékařská fakulta Masarykovy univerzity

⁴ I. dětská interní klinika, Fakultní nemocnice Brno a Lékařská Fakulta Masarykovy univerzity, Brno, Česká republika

Aim of study: To assess changes in left ventricular function in asymptomatic patients treated for malignancy in childhood.

Methods: The study included 33 patients aged 16.7 ± 1.7 years examined 11.9 ± 2.4 years after the completion of anthra-cycline chemotherapy (A), and 13 patients aged 16.3 ± 2.0 years examined 9.5 ± 2.9 years after completed chemotherapy without antracyclines (NonA). A control group (K) included 64 healthy adolescents aged 16.8 ± 1.2 years. All adolescents were examined using echocardiography with blood pressure measurement. All values were compared between the subgroups.

Results: When comparing groups A and NonA, no significant difference was found. When comparing groups A and K, we found a significantly lower ejection fraction (EF); p < 0.01, fractional shortening (FS); p < 0.001, systolic velocity of the septal mitral annulus (S sep); p < 0.001, systolic velocity of the lateral mitral annulus (S lat); p < 0.001, and early diastolic velocity of the septal mitral annulus (E'sep); p < 0.001. Group A in comparison with K also had a longer deceleration time (DT); p < 0.05, isovolumic relaxation time (IVRT); p < 0.001 and, also, a higher E/E' ratio of the septal mitral annulus (E/E'sep); p < 0.001. In the group of patients treated with other cytotoxic drugs (NonA), lower E'sep and S sep; p < 0.001; p < 0.001, longer IVRT; p < 0.001 and higher E/E'sep; p < 0.01 as compared with K were found. Both groups of patients (A, NonA) had significantly lower systolic blood pressure values; p < 0.001, p < 0.05, when compared with K.

Conclusions: Significant differences in diastolic left ventricular function were found between patients treated for malignancy in childhood and the healthy population. These results were expected in patients after comprehensive anticancer therapy including anthracyclines. The significant differences observed in the group treated with other drugs (Vinca alkaloids in particular) warrant more detailed study.

Keywords: Anthracyclines; Cardiotoxicity; Echocardiography; Diastolic function

Published: October 1, 2008  Show citation