Evaluation the Effect of Anthracyclines on Cardiac Function in Children Lymphoma Survivors by Left Ventricular Myocardial Work

Yuqiong An; Li Xue; Liyuan Xu; Chao Zhang; Yijie Yang; Yong Liu; Ning Ma

doi:10.1007/s00246-024-03480-2

Evaluation the Effect of Anthracyclines on Cardiac Function in Children Lymphoma Survivors by Left Ventricular Myocardial Work

Pediatr Cardiol. 2024 Apr 25. doi: 10.1007/s00246-024-03480-2. Online ahead of print.

Authors

Yuqiong An¹, Li Xue¹, Liyuan Xu¹, Chao Zhang¹, Yijie Yang¹, Yong Liu², Ning Ma³

Affiliations

¹ Heart Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, 56 Nanlishi Road, Xicheng District, Beijing, 100045, China.
² Department of Ultrasound, Beijing-Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
³ Heart Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, 56 Nanlishi Road, Xicheng District, Beijing, 100045, China. maning_echo@163.com.

PMID: 38662212
DOI: 10.1007/s00246-024-03480-2

Abstract

Anthracycline chemotherapy is associated with the left ventricular (LV) dysfunction, but the conventional echocardiographic parameter is insensitive in detecting subclinical cardiac dysfunction, and the role of echocardiography in children cancer survivors (CCSs) has not been well established. Here, the myocardial work (MW) was employed to evaluate the early effect of the anthracyclines on LV function in children lymphoma survivors, as well as to explore the clinical application value of this modality. 51 children lymphoma survivors treated with anthracyclines were included. During the treatments, the echocardiography was performed at baseline (T0 phase), the 3rd (T1 phase) and 6th (T2 phase) chemotherapeutic cycle, respectively. After that, the conventional echocardiographic parameters, LV global longitudinal strain (GLS), and global myocardial work (GMW) parameters were obtained. Finally, these echocardiographic parameters were compared to distinguish the differences among three groups, and correlation analysis was used to identify relationship between GMW parameters and LV GLS. Compared with the baseline, we found that there are no significant differences for LVEF and other conventional echocardiographic parameters after chemotherapy, but the value of LV lateral E/E' increased at T1 and T2 group. The GLS, global work index, global constructed work, and global work efficiency were decreased, while the global wasted work was increased after chemotherapy (all P < 0.05). The correlation analysis showed that the GLS has significant correlation with GMW parameters (all P < 0.001). The MW, as a new noninvasive echocardiography modality, could be used to quantitatively evaluate the LV MW in children lymphoma survivors treated with anthracyclines, which providing a sensitive method to early detect the children's LV dysfunction after the chemotherapy.

Keywords: Anthracyclines; Children; Global Longitudinal Strain; Global Myocardial Work; Pressure-Strain Loop.