title: Changes in echocardiographic measures of systolic and diastolic function in children 1 year after hematopoietic SCT.
abstract: Hematopoietic SCT (HSCT) is a life-saving therapy in children, but has been associated with heart failure. Little is known about subclinical changes in cardiac function. We examined changes in systolic and diastolic function from pre- to 1-year post HSCT by echocardiography. All patients (n=74, 61% men, median age 9.1 years, mean left-ventricular (LV) ejection fraction 61.3±4.9%) who underwent HSCT at Children's Hospital Boston between 2005 and 2008, were <21 years at time of HSCT, and had routine pre- and 1-year post echocardiograms were included. Systolic function parameters, including LV ejection fraction, rate-corrected velocity of fiber shortening (Vcfc) and stress-velocity index and diastolic parameters, including tissue Doppler imaging (TDI)-derived velocities, and left-ventricular flow propagation, were compared before and after transplant. At 1-year post HSCT, systolic function, as measured by Vcfc (1.10±0.15 vs 1.04±0.12 circ/s; P=0.03) and stress-velocity index (z-score 0.40±1.4 vs -0.20±1.1; P=0.02), had worsened; diastolic function parameters, including mitral E' velocity (16.6±3.9 vs 15.0±3.4 cm/s; P=0.01) and tricuspid E' velocity (14.3±3.6 vs 12.4±2.8 cm/s; P=0.002) had also decreased. At 1-year post HSCT, children have subclinical declines in systolic and diastolic function. These small changes might become clinically important over time. Serial non-invasive assessment of cardiac function should be considered in all children following HSCT.
authors.affiliation: Department of Cardiology, Children's Hospital Boston, Boston, MA 02115, USA. kevin.daly@childrens.harvard.edu
authors.forename: K P
authors.initials: KP
authors.lastname: Daly
authors.forename: S D
authors.initials: SD
authors.lastname: Colan
authors.forename: E D
authors.initials: ED
authors.lastname: Blume
authors.forename: R
authors.initials: R
authors.lastname: Margossian
authors.forename: K
authors.initials: K
authors.lastname: Gauvreau
authors.forename: C
authors.initials: C
authors.lastname: Duncan
authors.forename: L E
authors.initials: LE
authors.lastname: Lehmann
authors.forename: M H
authors.initials: MH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013318:Stroke Volume; D014184:Transplantation, Homologous; D055815:Young Adult