Assessment of left heart dysfunction to predict doxorubicin cardiotoxicity in children with lymphoma
作者全名:"Chen, Jiaqi; Cheng, Chunyue; Fan, Li; Xu, Xiaochuan; Chen, Jing; Feng, Yang; Tang, Yi; Yang, Chunjiang"
作者地址:"[Chen, Jiaqi; Fan, Li; Xu, Xiaochuan; Chen, Jing; Feng, Yang; Tang, Yi; Yang, Chunjiang] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Dept Ultrasound,Childrens Hosp,Minist Educ, Chongqing, Peoples R China; [Cheng, Chunyue] Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Wuhan Maternal & Child Healthcare Hosp, Tongji Med Coll,Childrens Hosp, Wuhan, Peoples R China"
通信作者:"Tang, Y; Yang, CJ (通讯作者),Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Dept Ultrasound,Childrens Hosp,Minist Educ, Chongqing, Peoples R China."
来源:FRONTIERS IN PEDIATRICS
ESI学科分类:CLINICAL MEDICINE
WOS号:WOS:000990539300001
JCR分区:Q2
影响因子:2.1
年份:2023
卷号:11
期号:
开始页:
结束页:
文献类型:Article
关键词:speckle-tracking echocardiography; cancer treatment-related cardiac dysfunction; longitudinal strain; children; left atrial strain
摘要:"ObjectivesThe objectives of this study were to assess the changes in the left myocardial function after chemotherapy for childhood lymphoma and observe the predictive or monitor value for cancer treatment-related cardiac dysfunction (CTRCD) by speckle-tracking echocardiography. MethodsA total of 23 children with histopathological diagnoses of lymphoma were included, with age-matched normal controls. Comparative analysis of clinical serological tests and left heart strain parameters in children with lymphoma, including left ventricular global longitudinal strain (LVGLS); global myocardial work (GMW) indices, which include global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency; and the LS of subendocardial, middle, and subepicardial layer myocardium during left ventricular systole were measured: left atrial strain of reservoir phase (LASr), left atrial strain of conduit phase (LAScd), and left atrial strain of contraction phase (LASct). ResultsOne-way ANOVA showed that GLS, GWI, GCW, LASr, and LAScd were closely associated with CTRCD and multivariate logistic regression analysis showed that GLS was the most sensitive predictor for detecting patients at lofty risk of anthracycline-related cardiotoxicity. Both before and after chemotherapy, GLS in the left ventricle showed a pattern of basal segment < middle segment < apical segment and subepicardial < middle < subendocardial layer (p < 0.05), and the degree of decrease also showed a regular pattern of epicardial layer < middle layer < subendocardial layer while the difference was not significant (p > 0.05). After chemotherapy, maximum flow rate in early mitral relaxation/left atrial systolic maximum flow rate (E/A) and left atrial volume index of each group were in the normal range, and the values of LASr, LAScd, and LASct slightly increased in the second cycle and decreased significantly in the fourth cycle after chemotherapy, reaching the lowest level; LASr and LAScd were positively correlated with GLS. ConclusionLVGLS is a more sensitive and earlier indicator to predict CTRCD compared with conventional echocardiography-related parameters and serological markers, and GLS of each myocardial layer showed a certain regularity. Left atrial strain can be used for early monitoring of cardiotoxicity in children with lymphoma after chemotherapy."
基金机构:Science Foundation of Chongqing [cstc2017shmsA130082]; Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2023MSXM097]
基金资助正文:"This work was supported by the Science Foundation of Chongqing (cstc2017shmsA130082) and Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau, 2023MSXM097)."