Cardio-oncology & otherCross-sectional study
Extensive Cardiac Function Analyses Using Contemporary Echocardiography in Childhood Cancer Survivors
- Cross-sectional study
- Median 26.7 years after diagnosis; 49% women
- Multivariable logistic regression
1,254 childhood cancer survivors (CCS) received cardiotoxic and 143 potentially cardiotoxic therapy
Authors' conclusion
Abnormal LVEF and GLS constitute complementary measures of systolic dysfunction among long-term CCS. Their diagnostic value may differ according to cardiotoxic exposures. Also, CCS have residual, unexplained risk of cardiac dysfunction.
Study context
- Population
- ≥5-year childhood cancer survivors treated with cardiotoxic or potentially cardiotoxic therapy, and siblings (Dutch Childhood Cancer Survivor Study)
- Participants
- 1,397 vs 277
- Exposure
- Childhood cancer survivors vs siblings
- CCSn = 1,397
- Siblingsn = 277reference
- Outcome
- Cardiac dysfunction on echocardiography (abnormal LVEF, abnormal GLS, diastolic dysfunction) and its risk factors
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Abnormal left ventricular ejection fraction (LVEF) (<52% men, <54% women) by treatment
- Most common with anthracyclines + RTheart combined
- 38%
Abnormal global longitudinal strain (GLS) (age/sex-specific) by treatment
- RTheart with anthracyclines
- 41%
- RTheart without anthracyclines
- 38%
Abnormal GLS in CCS with normal LVEF
- Abnormal GLS despite normal LVEF
- 20.2%
Diastolic dysfunction grade ≥II
- Rare
Risk factors for abnormal LVEF and GLS
- Abnormal LVEF: female sex, anthracycline dose, and only in women RTheart dose
- Abnormal GLS: female sex, RTheart dose, DBP, and only in women anthracycline dose
- Cyclophosphamide, ifosfamide and vincristine not associated with LVEF or GLS
Original publication
Summarised from the published abstract; every number is checked against it