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Article: Left ventricular myocardial deformation and mechanical dyssynchrony in children with normal ventricular shortening fraction after anthracycline therapy

TitleLeft ventricular myocardial deformation and mechanical dyssynchrony in children with normal ventricular shortening fraction after anthracycline therapy
Authors
Issue Date2010
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 2010, v. 96 n. 14, p. 1137-1141 How to Cite?
AbstractObjective: The M-mode-derived left ventricular shortening fraction is incorporated into most of the paediatric oncology protocols for monitoring of cardiotoxicity. This study tested the hypothesis that alteration of left ventricular myocardial deformation and mechanical dyssynchrony may occur in asymptomatic children after anthracycline therapy despite having left ventricular shortening fractions within the limits of normal. Design: Cross-sectional study. Setting: Tertiary paediatric cardiac centre. Methods: Left ventricular longitudinal, circumferential and radial myocardial deformation was determined using speckle tracking echocardiography in 45 patients aged 15.3±5.8 years. Real-time three-dimensional echocardiographic data were acquired for the measurement of left ventricular volumes and systolic dyssynchrony index (SDI), the latter derived from the dispersion of time-to-minimum regional volume using a 16-segment model. The results were compared with those of 44 controls. Results: Compared with controls, patients had reduced left ventricular global systolic longitudinal strain (p=0.012), circumferential strain (p<0.001), radial strain (p=0.006) and circumferential strain rate (SR; p=0.002). The cumulative anthracycline dose correlated negatively with global longitudinal (r=-0.33, p=0.027) and circumferential (r=-0.32, p=0.035) SR. The left ventricular SDI was significantly greater in patients than controls (4.46±1.52% vs 3.80±0.58%, p=0.03). The prevalence of left ventricular mechanical dyssynchrony (SDI >4.96%) in patients was 16% (95% CI 6% to 29%). In patients, SDI correlated negatively with left ventricular ejection fraction (r=-0.52, p<0.001), radial strain (r=-0.35, p=0.021), circumferential strain (r=-0.37, p=0.015) and circumferential SR (r=-0.43, p=0.004), but not with the cumulative anthracycline dose (p=0.82). Conclusions: Impaired left ventricular myocardial deformation and mechanical dyssynchrony may exist in children after anthracycline therapy despite having normal left ventricular shortening fractions.
Persistent Identifierhttp://hdl.handle.net/10722/124155
ISSN
2015 Impact Factor: 5.693
2015 SCImago Journal Rankings: 2.647
ISI Accession Number ID
Funding AgencyGrant Number
Children's Cancer Foundation
CRCG
University of Hong Kong
Funding Information:

This study is supported by the Children's Cancer Foundation and CRCG funding, the University of Hong Kong.

References

 

DC FieldValueLanguage
dc.contributor.authorCheung, YFen_HK
dc.contributor.authorHong, WJen_HK
dc.contributor.authorChan, GCFen_HK
dc.contributor.authorWong, SJen_HK
dc.contributor.authorHa, SYen_HK
dc.date.accessioned2010-10-27T06:46:33Z-
dc.date.available2010-10-27T06:46:33Z-
dc.date.issued2010en_HK
dc.identifier.citationHeart, 2010, v. 96 n. 14, p. 1137-1141en_HK
dc.identifier.issn1355-6037en_HK
dc.identifier.urihttp://hdl.handle.net/10722/124155-
dc.description.abstractObjective: The M-mode-derived left ventricular shortening fraction is incorporated into most of the paediatric oncology protocols for monitoring of cardiotoxicity. This study tested the hypothesis that alteration of left ventricular myocardial deformation and mechanical dyssynchrony may occur in asymptomatic children after anthracycline therapy despite having left ventricular shortening fractions within the limits of normal. Design: Cross-sectional study. Setting: Tertiary paediatric cardiac centre. Methods: Left ventricular longitudinal, circumferential and radial myocardial deformation was determined using speckle tracking echocardiography in 45 patients aged 15.3±5.8 years. Real-time three-dimensional echocardiographic data were acquired for the measurement of left ventricular volumes and systolic dyssynchrony index (SDI), the latter derived from the dispersion of time-to-minimum regional volume using a 16-segment model. The results were compared with those of 44 controls. Results: Compared with controls, patients had reduced left ventricular global systolic longitudinal strain (p=0.012), circumferential strain (p<0.001), radial strain (p=0.006) and circumferential strain rate (SR; p=0.002). The cumulative anthracycline dose correlated negatively with global longitudinal (r=-0.33, p=0.027) and circumferential (r=-0.32, p=0.035) SR. The left ventricular SDI was significantly greater in patients than controls (4.46±1.52% vs 3.80±0.58%, p=0.03). The prevalence of left ventricular mechanical dyssynchrony (SDI >4.96%) in patients was 16% (95% CI 6% to 29%). In patients, SDI correlated negatively with left ventricular ejection fraction (r=-0.52, p<0.001), radial strain (r=-0.35, p=0.021), circumferential strain (r=-0.37, p=0.015) and circumferential SR (r=-0.43, p=0.004), but not with the cumulative anthracycline dose (p=0.82). Conclusions: Impaired left ventricular myocardial deformation and mechanical dyssynchrony may exist in children after anthracycline therapy despite having normal left ventricular shortening fractions.en_HK
dc.languageeng-
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_HK
dc.relation.ispartofHearten_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsHeart. Copyright © B M J Publishing Group.-
dc.subject.meshAdolescent-
dc.subject.meshAnthracyclines - adverse effects-
dc.subject.meshAntibiotics, Antineoplastic - adverse effects - therapeutic use-
dc.subject.meshCase-Control Studies-
dc.subject.meshVentricular Dysfunction, Left - chemically induced - physiopathology - ultrasonography-
dc.titleLeft ventricular myocardial deformation and mechanical dyssynchrony in children with normal ventricular shortening fraction after anthracycline therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1355-6037&volume=96&issue=14&spage=1137&epage=1141&date=2010&atitle=Left+ventricular+myocaridal+deformation+and+mechanical+dyssynchrony+in+children+with+normal+ventricular+shortening+fraction+after+anthracycline+therapy-
dc.identifier.emailCheung, YF:xfcheung@hku.hken_HK
dc.identifier.emailChan, GCF:gcfchan@hkucc.hku.hken_HK
dc.identifier.authorityCheung, YF=rp00382en_HK
dc.identifier.authorityChan, GCF=rp00431en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1136/hrt.2010.194118en_HK
dc.identifier.pmid20511624-
dc.identifier.scopuseid_2-s2.0-77954443491en_HK
dc.identifier.hkuros172985-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77954443491&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume96en_HK
dc.identifier.issue14en_HK
dc.identifier.spage1137en_HK
dc.identifier.epage1141en_HK
dc.identifier.isiWOS:000279531800011-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheung, YF=7202111067en_HK
dc.identifier.scopusauthoridHong, WJ=14010481700en_HK
dc.identifier.scopusauthoridChan, GCF=16160154400en_HK
dc.identifier.scopusauthoridWong, SJ=25924109100en_HK
dc.identifier.scopusauthoridHa, SY=7202501115en_HK

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