Background: Cardiovascular disease is the leading non-cancer cause of death among survivors
of childhood cancer. Ejection fraction (EF) and fractional shortening (FS) are common
echocardiographic measures of cardiac function. Newer analysis modalities, including radial
displacement, may provide additional information about pre-clinical disease such as regional
myocardial dysfunction. Methods: We compared mean radial displacement, EF, and FS among
adult survivors of childhood cancer exposed to ≥ 250 mg/m2 of anthracyclines to age, sexmatched
healthy controls. Survivors with a history of cardiac directed radiation, diabetes, or
heart disease were excluded. Results: There were no differences in gender (35% male vs. 35%
male, p=1.0) or current age (28.4 years (range18-50) vs. 28.7 years (range 18-50), p=0.94)
between survivors and controls, respectively. Among survivors mean age at diagnosis was 12.5
(range 1-20) years, mean survival time 16 (range 5-30) years, and mean anthracycline exposure
was 420 (range 300-645) mg/m2. FS (35.5% vs. 39.6%, p < 0.01) and radial displacement (5.6
mm vs. 6.7 mm, p = 0.02) were significantly lower in cancer survivors as compared to controls.
EF showed a trend towards being lower in survivors versus controls (55.4% vs. 59.7%, p =
0.057). All echocardiographic measures were inversely related with dose of anthracyclines,
though radial displacement was no longer significantly correlated with antrhacycline dose after
controlling for survival time (p = 0.07) while EF remained correlated (p = 0.003). Conclusions:
Novel and traditional measures of radial displacement, FS, and EF are lower in childhood cancer
survivors in long-term follow-up compared to controls. Novel measures may add new
information, but the potential clinical utility remains undetermined and requires further
University of Minnesota M.S. thesis. Major: Clinical research. Advisor: Daniel A. Mulrooney, M.D., M.S.; 1 computer file (PDF); v, 33 pages, appendix p. 26-29.
Dietz, Andrew Charles.
Evaluation of traditional and novel measures of cardiac fucntion to detect anthracycline induced cardiotoxicity in survivors of childhood cancer.
Retrieved from the University of Minnesota Digital Conservancy,
Content distributed via the University of Minnesota's Digital Conservancy may be subject to additional license and use restrictions applied by the depositor.