Clinical Investigation3D Echocardiography: Value-Added ApplicationsNew Three-Dimensional Speckle-Tracking Echocardiography Identifies Global Impairment of Left Ventricular Mechanics with a High Sensitivity in Childhood Cancer Survivors
Section snippets
Subjects
This was a case-control study. Fifty-three anthracycline-treated survivors of childhood cancers who had been off treatment for ≥1 year were consecutively recruited from the oncology clinic. The following data were collected from the case notes: diagnosis, duration of follow-up, cumulative dose of anthracyclines, clinical evidence of heart failure, and the need for cardiac medications. Thirty-eight control subjects were studied. The healthy volunteers were invited to participate in the study by
Subjects
The 53 patients were aged 18.6 ± 5.1 years at the time of study. The diagnoses included acute lymphoblastic leukemia (n = 26), acute myeloid leukemia (n = 10), osteosarcoma (n = 8), Burkitt lymphoma (n = 3), Hodgkin lymphoma (n = 2), non-Hodgkin lymphoma (n = 1), synovial sarcoma (n = 1), neuroblastoma (n = 1), and hepatoblastoma (n = 1). All patients had received anthracycline-based regimens, and the median cumulative anthracycline dose was 229 mg/m2 (range, 40–644 mg/m2). Patients were
Discussion
The present study represents the first attempt to interrogate global and regional performance of the left ventricle using 3D STE in childhood cancer survivors. Our findings show impairment of global and regional myocardial deformation in three dimensions, reduced torsion, and systolic dyssynchrony in adolescents and young adults after anthracycline therapy. We have further introduced a new index of global LV performance that reflects all of the aforementioned perturbations of LV mechanics and
Conclusions
Notwithstanding its limitations, the new 3D imaging modality in its present form enables the derivation of an index of LV global performance that incorporates LV 3D strain, dyssynchrony, and torsion for the sensitive detection of altered LV mechanics in childhood cancer survivors.
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Cited by (0)
This study was supported by the Children's Cancer Foundation (Hong Kong, China).