Journal
AMERICAN JOURNAL OF CARDIOLOGY
Volume 113, Issue 11, Pages 1886-1892Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2014.03.019
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Funding
- Blood Disease Research Foundation, Helsinki
- Competitive Research Funding of the Tampere University Hospital, Tampere [9L114, 9N084]
- EVO funds of the Tampere University Hospital, Tampere
- Emil Aaltonen Foundation, Tampere
- Finnish Association of Hematology, Helsinki
- Finnish Cancer Foundation, Helsinki
- Finnish Cultural Foundation, Helsinki
- Finnish Cultural Foundation Pirkanmaa Regional Fund, Ylojarvi
- Foundation for Pediatric Research, Helsinki
- National Graduate School of Clinical Investigations, Helsinki
- Paivikki and Sakari Sohlberg Foundation, Helsinki
- Scientific Foundation of the City of Tampere, Tampere
- Vare Foundation for Pediatric Cancer, Helsinki
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The left ventricular (LV) volumes, ejection fraction (EF), and dyssynchrony indexes for the 16 and 12 cardiac segments (Tmsv16-SD and Tmsv12-SD, respectively) were analyzed among nonadult, anthracycline-exposed long-term survivors of childhood cancer and compared with those of healthy controls using conventional and real-time 3-dimensional echocardiography (RT-3DE) with cardiac magnetic resonance (CMR) imaging in a prospective, cross-sectional, single tertiary center setting. Seventy-one survivors and gender-, body surface area-, and age-matched healthy controls were studied by conventional echocardiography and RT-3DE. Fifty-eight of the 71 survivors underwent also CMR. The survivors were evaluated in 2 groups. Group I consisted of 63 exposed to anthracyclines and group II consisted of 8 also exposed to cardiac irradiation. By RT-3DE, the group I survivors had a lower LVEF (57% vs 60%, respectively, p = 0.003) and larger body surface area indexed LV end-systolic volume (31 vs 28 ml/m(2), respectively, p = 0.001) than controls. The Tmsv16-SD was higher in group II than in I (1.93% vs 1.39%, respectively, p = 0.003). None of the survivors had an abnormal fractional shortening (<28%), but 10% had an LVEF <50% by RT-3DE. An LVEF <55% was detected in 45 of 58 (78%) of those imaged with CMR. In conclusion, RT-3DE seems to detect more abnormalities in cardiac function than conventional echocardiography following childhood cancer therapy. The LV dyssynchrony indexes derived from RT-3DE appear potentially useful in assessing the early signs of cardiotwdcity between anthracycline and cardiac irradiation exposed long-term survivors of childhood cancer. (C) 2014 Elsevier Inc. All rights reserved.
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