[Evaluation of systolic and diastolic function of the left ventricle in children with acute lymphoblastic leukaemia before treatment].
Between 1995 and 2001 echo-cardiography was performed in 244 children (128 boys, 116 girls) with acute lymphoblastic leukaemia (ALL) before the beginning of therapy with anthracyclines (medium 5.4 days after the diagnosis). The mean age at diagnosis was 5.4 years (range 9 months to 17.7 years). 189 children (97 boys and 92 girls) were included into the standard and medium risk groups and 55 (31 boys and 24 girls) into the high risk group. 29% of ALL children had disturbances in ECG. Changes in the thickness of the intraventricular septum (%IVSTh) and left ventricular posterior wall (%LVPWTh) were statistically lower, especially in children under 7 years of age. Some children showed lowering of shortening fraction (%FS - 8.6%), ejection fraction (%EF - 10.2%) and corrected velocity of fibber-shortening (Vcfc - 25.8%). Children with decreased shortening fraction (%FS) had left ventricular posterior wall thickness (%LVPWTh) impairment. Changes in diastolic function indicate impaired relaxation and compliance of the left ventricle. Decreased peak early filling velocity (E) was found. There were also longer deceleration time (EDecT) and decreased deceleration from peak E velocity (E/Dec) and longer isovolumetric relaxation time in children in standard and medium risk groups. Shorter acceleration time (EAccT) was seen in the high risk group. Evaluation of cardiac function before anthracycline chemotherapy will allow to select patients with pre-existing cardiac impairment for whom cardioprotective treatment is absolutely necessary.
Jackowska
Teresa
T
Katedra i Klinika Pediatrii, Hematologii i Onkologii, Akademii Medycznej w Warszawie. tjackowska@litewska.edu.pl
Pleskot
Marek
M
Gołabek
Małgorzata
M
Rokicka-Milewska
Roma
R
Wróblewska-Kałuzewska
Maria
M
Wypych
Agnieszka
A
Matysiak
Michał
M
Klus
Kinga
K
Juraszewska
Ewa
E
Balwierz
Walentyna
W
Wójcik
Beata
B
Sadurska
Elzbieta
E
Kowalczyk
Jerzy
J
Stencel
Dariusz
D
Siwinska
Aldona
A
Wachowiak
Jacek
J
Szmyd
Krzysztof
K
Kukawczyńska
Ewa
E
Chybicka
Alicja
A
Płoszyńska
Anna
A
Aleszewicz-Baranowska
Janina
J
Balcerska
Anna
A
Ostański
Mariusz
M
Pobudejska
Agnieszka
A
Sońta-Jakimczyk
Danuta
D
Krenke
Katarzyna
K
Madry
Wojtek
W
Syczewska
Małgorzata
M
Rudziński
Andrzej
A
D000293:Adolescent; D000367:Age Factors; D018943:Anthracyclines / Q000008:administration & dosage; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011044:Poland; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D012189:Retrospective Studies; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D017725:Ventricular Pressure
D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic