Exercise echocardiography reveals subclinical cardiac dysfunction in young adult survivors of childhood acute lymphoblastic leukemia

2.50
Hdl Handle:
http://hdl.handle.net/2336/14496
Title:
Exercise echocardiography reveals subclinical cardiac dysfunction in young adult survivors of childhood acute lymphoblastic leukemia
Authors:
Jarfelt, M; Kujacic, V; Holmgren, D; Bjarnason, R; Lannering, B
Citation:
Pediatr Blood Cancer 2007, 49(6):835-40
Issue Date:
1-Nov-2007
Abstract:
OBJECTIVE: Anthracyclines (AC) have contributed significantly to increased survival rate in acute lymphoblastic leukemia (ALL), although the use of these drugs is limited due to cardiotoxicity. The aim was to evaluate heart muscle function in asymptomatic adult survivors of ALL treated in early childhood in relation to the combined effects of AC and other potential cardiotoxic factors. PROCEDURE: Twenty-three young adult ALL survivors who had all received treatment with median 120 (120-400) mg AC/m(2) before the onset of puberty were examined median 21 years after remission and compared with 12 healthy controls. Basal echocardiography including two-dimensional (2D) M-mode and Doppler examination was performed, followed by a maximal exercise stress test and stress echocardiography immediately after stress test and after 5 min recovery. RESULTS: We found significant differences in systolic function between patients and controls at maximal exercise despite absence of reported symptoms from the patients. The most marked difference was in ejection fraction at stress 59.5% (32.6-81.1) and 77.3% (66.2-85.3), respectively (P < 0.00006). Ten out of 23 patients reduced their ejection fraction at stress compared with at rest; this was not found in any of the controls. Cardiovascular risk factors such as GH deficiency and a high proportion of trunk fat did not have an impact on cardiac function. CONCLUSIONS: With very long follow up in a homogenous cohort of ALL survivors, we found subclinical cardiac dysfunction with exercise stress echocardiography even after low doses of AC.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Link field
Additional Links:
http://dx.doi.org/10.1002/pbc.21289

Full metadata record

DC FieldValue Language
dc.contributor.authorJarfelt, M-
dc.contributor.authorKujacic, V-
dc.contributor.authorHolmgren, D-
dc.contributor.authorBjarnason, R-
dc.contributor.authorLannering, B-
dc.date.accessioned2007-11-07T11:18:27Z-
dc.date.available2007-11-07T11:18:27Z-
dc.date.issued2007-11-01-
dc.date.submitted2007-11-07-
dc.identifier.citationPediatr Blood Cancer 2007, 49(6):835-40en
dc.identifier.issn1545-5009-
dc.identifier.pmid17610264-
dc.identifier.doi10.1002/pbc.21289-
dc.identifier.otherPED12-
dc.identifier.urihttp://hdl.handle.net/2336/14496-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Link fielden
dc.description.abstractOBJECTIVE: Anthracyclines (AC) have contributed significantly to increased survival rate in acute lymphoblastic leukemia (ALL), although the use of these drugs is limited due to cardiotoxicity. The aim was to evaluate heart muscle function in asymptomatic adult survivors of ALL treated in early childhood in relation to the combined effects of AC and other potential cardiotoxic factors. PROCEDURE: Twenty-three young adult ALL survivors who had all received treatment with median 120 (120-400) mg AC/m(2) before the onset of puberty were examined median 21 years after remission and compared with 12 healthy controls. Basal echocardiography including two-dimensional (2D) M-mode and Doppler examination was performed, followed by a maximal exercise stress test and stress echocardiography immediately after stress test and after 5 min recovery. RESULTS: We found significant differences in systolic function between patients and controls at maximal exercise despite absence of reported symptoms from the patients. The most marked difference was in ejection fraction at stress 59.5% (32.6-81.1) and 77.3% (66.2-85.3), respectively (P < 0.00006). Ten out of 23 patients reduced their ejection fraction at stress compared with at rest; this was not found in any of the controls. Cardiovascular risk factors such as GH deficiency and a high proportion of trunk fat did not have an impact on cardiac function. CONCLUSIONS: With very long follow up in a homogenous cohort of ALL survivors, we found subclinical cardiac dysfunction with exercise stress echocardiography even after low doses of AC.en
dc.language.isoenen
dc.publisherJohn Wileyen
dc.relation.urlhttp://dx.doi.org/10.1002/pbc.21289en
dc.subject.meshEchocardiography, Doppleren
dc.subject.meshExercise Testen
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphomaen
dc.titleExercise echocardiography reveals subclinical cardiac dysfunction in young adult survivors of childhood acute lymphoblastic leukemiaen
dc.typeArticleen
dc.identifier.journalPediatric blood & canceren
dc.format.digYES-

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