Ventricular systolic reserve in asymptomatic children previously treated with low doses of anthracyclines: A longitudinal, prospective exercise echocardiography study
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Data
2012-09-01
Autores
Guimaraes-Filho, Fabio V.
Tan, Doralice M.
Braga, Joao C.F.
Rodrigues, Alexandre
Waib, Paulo H.
Matsubara, Beatriz Bojikian [UNESP]
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Resumo
Background: The time course of mild cardiotoxicity induced by anthracycline remains unknown. The aim of this study was to evaluate the long-term evolution of decreased myocardial reserve in children previously treated with a cumulative dose of anthracycline up to 100mg/m 2. Patients and Methods: Twenty-seven asymptomatic cancer survival patients (25 with lymphoblastic leukemia), in continuous remission and off treatment for >12 months with no alterations in conventional echocardiograms were evaluated by exercise echocardiography at 37±15.4 months (T1) and 101±24 months (T2) after finishing treatment (ADRIA group). This group was compared with 25 healthy individuals (control group) similar to the ADRIA group with respect to age and body surface area (BSA). All individuals underwent treadmill exercise testing according to Bruce protocol. Echocardiograms were performed before and immediately after exercise. Results: The groups were similar regarding cardiac structure and left ventricular (LV) systolic function at rest at T1 and T2. The growth of LV posterior wall thickness related to BSA was lower in the ADRIA group at T2. Post exercise, smaller LV ejection indexes and attenuated changes in the afterload in ADRIA group were observed at T1 and T2. Conclusion: The decreased systolic reserve induced by a low dose of anthracycline in asymptomatic children and adolescents remains unaffected over a 5-year period, suggesting that positive outcomes in chronic cardiotoxicity would be expected in patients with mild impairment after anthracycline treatment. © 2011 Wiley Periodicals, Inc.
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Anthracycline, Cancer, Children, Echocardiography, Heart, daunorubicin, doxorubicin, acute lymphoblastic leukemia, age, body surface, cancer chemotherapy, cancer regression, cancer survivor, case control study, child, childhood cancer, clinical article, controlled study, diastolic blood pressure, exercise echocardiography, female, heart left ventricle ejection fraction, heart rate, heart ventricle function, heart ventricle systolic reserve, hemodynamic parameters, human, longitudinal study, low drug dose, lymphoblastoma, male, priority journal, prospective study, rhabdomyosarcoma, school child, side effect, stress echocardiography, systolic blood pressure, treadmill exercise, treatment duration, Adolescent, Anthracyclines, Antibiotics, Antineoplastic, Child, Child, Preschool, Exercise, Female, Heart Ventricles, Humans, Infant, Longitudinal Studies, Male, Neoplasms, Prospective Studies, Rest, Systole, Ventricular Function, Left
Como citar
Pediatric Blood and Cancer, v. 59, n. 3, p. 548-552, 2012.