Effect of anthracycline therapy on myocardial function and markers of fibrotic remodelling in childhood cancer survivors

التفاصيل البيبلوغرافية
العنوان: Effect of anthracycline therapy on myocardial function and markers of fibrotic remodelling in childhood cancer survivors
المؤلفون: Wadi Mawad, Peter Liu, Joseph J Pagano, Paul C. Nathan, Lars Grosse-Wortmann, Marjolein J. E. Reichert, Seema Mital, Mark T. Greenberg, Eugenie Riesenkampff, Luc Mertens, Paul F. Kantor
المصدر: Eur Heart J Cardiovasc Imaging
سنة النشر: 2019
مصطلحات موضوعية: Cardiac function curve, medicine.medical_specialty, Anthracycline, Diastole, Magnetic Resonance Imaging, Cine, 030204 cardiovascular system & hematology, Asymptomatic, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Cancer Survivors, Internal medicine, Neoplasms, medicine, Humans, Radiology, Nuclear Medicine and imaging, Anthracyclines, Systole, Child, Ejection fraction, business.industry, Myocardium, fungi, General Medicine, Original Articles, Fibrosis, 3. Good health, Cohort, Cardiology, Myocardial fibrosis, medicine.symptom, Cardiology and Cardiovascular Medicine, business
الوصف: Aims Anthracyclines are a cornerstone of paediatric cancer treatment. We aimed to quantify myocardial cardiac magnetic resonance (CMR) native T1 (NT1) and extracellular volume fraction (ECV) as markers of fibrosis in a cohort of childhood cancer survivors (CCS). Methods and results A cohort of CCS in remission underwent CMR T1 mapping. Diastolic function was assessed by echocardiography. Results were compared to a cohort of normal controls of similar age and gender. Fifty-five CCS and 46 controls were included. Both groups had similar mean left ventricular (LV) NT1 values (999 ± 36 vs. 1007 ± 32 ms, P = 0.27); ECV was higher (25.6 ± 6.9 vs. 20.7 ± 2.4%, P = 0.003) and intracellular mass was lower (37.5 ± 8.4 vs. 43.3 ± 9.9g/m2, P = 0.02) in CCS. The CCS group had lower LV ejection fraction (EF) and LV mass index with otherwise normal diastolic function in all but one patient. The proportion of subjects with elevated ECV compared to controls did not differ between subgroups with normal or reduced LV EF (22% vs. 28%; P = 0.13) and no correlations were found between LVEF and ECV. While average values remained within normal range, mitral E/E′ (6.6 ± 1.6 vs. 5.9 ± 0.9, P = 0.02) was higher in CCS. Neither NT1 nor ECV correlated with diastolic function indices or cumulative anthracycline dose. Conclusions There is evidence for mild diffuse extracellular volume expansion in some asymptomatic CCS; myocyte loss could be part of the mechanism, accompanied by subtle changes in systolic and diastolic function. These findings suggest mild myocardial damage and remodelling after anthracycline treatment in some CCS which requires continued monitoring.
تدمد: 2047-2412
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aaa1e65a88346d88fcedb793bb1a8b60
https://pubmed.ncbi.nlm.nih.gov/32535624
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....aaa1e65a88346d88fcedb793bb1a8b60
قاعدة البيانات: OpenAIRE