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Article: Left ventricular twisting and untwisting motion in childhood cancer survivors
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TitleLeft ventricular twisting and untwisting motion in childhood cancer survivors
 
AuthorsCheung, YF1
Li, SN1
Chan, GCF1
Wong, SJ1
Ha, SY1
 
Keywordsanthracycline cardiotoxicity
childhood cancer survivors
ventricular torsion
 
Issue Date2011
 
PublisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ECHO
 
CitationEchocardiography, 2011, v. 28 n. 7, p. 738-745 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8175.2011.01429.x
 
AbstractBackground: Anthracycline has been shown to degrade titin that plays a role in myocardial twisting and untwisting. This study aimed to test the hypothesis that left ventricular (LV) twisting and untwisting motion may be altered in children after anthracycline therapy. Methods: Thirty-six childhood leukemia survivors aged 15.6 ± 5.5 years and 20 healthy controls aged 16.8 ± 7.7 years (P = 0.54) were studied. LV twisting and untwisting motion was determined using speckle tracking imaging, whereas LV ejection fraction and systolic and diastolic mitral annular velocities were determined respectively by three-dimensional and tissue-Doppler echocardiography. Results: Compared with controls, patients had significantly lower LV ejection fraction (P = 0.01) but similar systolic and diastolic mitral annular velocities (all P > 0.05). Their peak LV torsion (P = 0.003), systolic twisting velocity (P < 0.001), and diastolic untwisting velocity (P = 0.04) were significantly lower than controls, which could be attributable to their reduced apical rotation (P = 0.03) and apical untwisting rate (P = 0.002). For the whole cohort, LV systolic torsion and twisting velocity correlated significantly with apical untwisting rate (P < 0.001) and LV diastolic untwisting velocity (P < 0.001). In patients, none of the twisting or untwisting parameters were found to correlate with cumulative anthracycline dose (all P > 0.05). Twenty-eight (78%) patients had LV ejection fractions ≥50%. Although their systolic and diastolic mitral annular velocities were similar to those of controls, their peak LV torsion (P = 0.005), apical untwisting rate (P = 0.01), and LV systolic twisting velocity (P = 0.001) remained significantly lower. Conclusion: Impairment of LV twisting and untwisting motion is evident in children after anthracycline therapy, even in those with "normal" LV ejection fractions. © 2011, Wiley Periodicals, Inc.
 
ISSN0742-2822
2012 Impact Factor: 1.261
2012 SCImago Journal Rankings: 0.506
 
DOIhttp://dx.doi.org/10.1111/j.1540-8175.2011.01429.x
 
ISI Accession Number IDWOS:000293906200015
Funding AgencyGrant Number
Children's Cancer Foundation
CRCG, University of Hong Kong
Funding Information:

Children's Cancer Foundation and CRCG funding, The University of Hong Kong.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheung, YF
 
dc.contributor.authorLi, SN
 
dc.contributor.authorChan, GCF
 
dc.contributor.authorWong, SJ
 
dc.contributor.authorHa, SY
 
dc.date.accessioned2011-07-27T01:33:44Z
 
dc.date.available2011-07-27T01:33:44Z
 
dc.date.issued2011
 
dc.description.abstractBackground: Anthracycline has been shown to degrade titin that plays a role in myocardial twisting and untwisting. This study aimed to test the hypothesis that left ventricular (LV) twisting and untwisting motion may be altered in children after anthracycline therapy. Methods: Thirty-six childhood leukemia survivors aged 15.6 ± 5.5 years and 20 healthy controls aged 16.8 ± 7.7 years (P = 0.54) were studied. LV twisting and untwisting motion was determined using speckle tracking imaging, whereas LV ejection fraction and systolic and diastolic mitral annular velocities were determined respectively by three-dimensional and tissue-Doppler echocardiography. Results: Compared with controls, patients had significantly lower LV ejection fraction (P = 0.01) but similar systolic and diastolic mitral annular velocities (all P > 0.05). Their peak LV torsion (P = 0.003), systolic twisting velocity (P < 0.001), and diastolic untwisting velocity (P = 0.04) were significantly lower than controls, which could be attributable to their reduced apical rotation (P = 0.03) and apical untwisting rate (P = 0.002). For the whole cohort, LV systolic torsion and twisting velocity correlated significantly with apical untwisting rate (P < 0.001) and LV diastolic untwisting velocity (P < 0.001). In patients, none of the twisting or untwisting parameters were found to correlate with cumulative anthracycline dose (all P > 0.05). Twenty-eight (78%) patients had LV ejection fractions ≥50%. Although their systolic and diastolic mitral annular velocities were similar to those of controls, their peak LV torsion (P = 0.005), apical untwisting rate (P = 0.01), and LV systolic twisting velocity (P = 0.001) remained significantly lower. Conclusion: Impairment of LV twisting and untwisting motion is evident in children after anthracycline therapy, even in those with "normal" LV ejection fractions. © 2011, Wiley Periodicals, Inc.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationEchocardiography, 2011, v. 28 n. 7, p. 738-745 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8175.2011.01429.x
 
dc.identifier.citeulike9741570
 
dc.identifier.doihttp://dx.doi.org/10.1111/j.1540-8175.2011.01429.x
 
dc.identifier.epage745
 
dc.identifier.hkuros187930
 
dc.identifier.hkuros194352
 
dc.identifier.isiWOS:000293906200015
Funding AgencyGrant Number
Children's Cancer Foundation
CRCG, University of Hong Kong
Funding Information:

Children's Cancer Foundation and CRCG funding, The University of Hong Kong.

 
dc.identifier.issn0742-2822
2012 Impact Factor: 1.261
2012 SCImago Journal Rankings: 0.506
 
dc.identifier.issue7
 
dc.identifier.pmid21615484
 
dc.identifier.scopuseid_2-s2.0-80955178801
 
dc.identifier.spage738
 
dc.identifier.urihttp://hdl.handle.net/10722/135338
 
dc.identifier.volume28
 
dc.languageeng
 
dc.publisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ECHO
 
dc.publisher.placeUnited States
 
dc.relation.ispartofEchocardiography
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThe definitive version is available at www.blackwell-synergy.com
 
dc.subject.meshAnthracyclines - adverse effects - therapeutic use
 
dc.subject.meshEchocardiography, Doppler - methods
 
dc.subject.meshEchocardiography, Three-Dimensional - methods
 
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
 
dc.subject.meshVentricular Dysfunction, Left - chemically induced - physiopathology - ultrasonography
 
dc.subjectanthracycline cardiotoxicity
 
dc.subjectchildhood cancer survivors
 
dc.subjectventricular torsion
 
dc.titleLeft ventricular twisting and untwisting motion in childhood cancer survivors
 
dc.typeArticle
 
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<contributor.author>Ha, SY</contributor.author>
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<description.abstract>Background: Anthracycline has been shown to degrade titin that plays a role in myocardial twisting and untwisting. This study aimed to test the hypothesis that left ventricular (LV) twisting and untwisting motion may be altered in children after anthracycline therapy. Methods: Thirty-six childhood leukemia survivors aged 15.6 &#177; 5.5 years and 20 healthy controls aged 16.8 &#177; 7.7 years (P = 0.54) were studied. LV twisting and untwisting motion was determined using speckle tracking imaging, whereas LV ejection fraction and systolic and diastolic mitral annular velocities were determined respectively by three-dimensional and tissue-Doppler echocardiography. Results: Compared with controls, patients had significantly lower LV ejection fraction (P = 0.01) but similar systolic and diastolic mitral annular velocities (all P &gt; 0.05). Their peak LV torsion (P = 0.003), systolic twisting velocity (P &lt; 0.001), and diastolic untwisting velocity (P = 0.04) were significantly lower than controls, which could be attributable to their reduced apical rotation (P = 0.03) and apical untwisting rate (P = 0.002). For the whole cohort, LV systolic torsion and twisting velocity correlated significantly with apical untwisting rate (P &lt; 0.001) and LV diastolic untwisting velocity (P &lt; 0.001). In patients, none of the twisting or untwisting parameters were found to correlate with cumulative anthracycline dose (all P &gt; 0.05). Twenty-eight (78%) patients had LV ejection fractions &#8805;50%. Although their systolic and diastolic mitral annular velocities were similar to those of controls, their peak LV torsion (P = 0.005), apical untwisting rate (P = 0.01), and LV systolic twisting velocity (P = 0.001) remained significantly lower. Conclusion: Impairment of LV twisting and untwisting motion is evident in children after anthracycline therapy, even in those with &quot;normal&quot; LV ejection fractions. &#169; 2011, Wiley Periodicals, Inc.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong