title: Tissue Doppler evaluation of systolic and diastolic cardiac functions in long-term survivors of Hodgkin lymphoma.
abstract: BACKGROUND
  Monitoring for late adverse events is crucial in long-term management of childhood cancer survivors. A case-control study to evaluate long-term cardiovascular status of childhood Hodgkin lymphoma (HL) using tissue Doppler imaging (TDI) was performed.
  
  
  METHODS
  Patients diagnosed with HL before age of 18 that completed therapy and were in remission and a control group of healthy children were evaluated by echocardiography and TDI.
  
  
  RESULTS
  Total of 72 HL survivors were included in the study. Median age at diagnosis, remission time, and age at time of echocardiography were 7 (2-16), 9 (2-20), and 17.5 (7-27) years, respectively. TDI revealed decreased S' velocity, reflecting systolic dysfunction in HL survivors, at medial and lateral mitral annuli and at middle segment of interventricular septum (IVS; P < 0.01) for all. Moreover, TDI showed decreased peak E' velocity at medial mitral annulus [12.4 cm/s (5.5-16.3) vs. 13.3 cm/s (10.2-18.9), P = 0.03] and at middle segment of IVS [10 cm/s (5.3-16.3) vs. 11.6 cm/s (6.7-16.7), P < 0.01] and prolongation of isovolemic relaxation time at medial and lateral annuli of the mitral valve (P < 0.01) and at middle segment of IVS (P = 0.03) suggesting diastolic dysfunction in HL survivors.
  
  
  CONCLUSIONS
  Cardiac dysfunction after childhood cancer therapy may develop after many years. Since systolic and diastolic dysfunction can be seen in these patients periodic echocardiographic screening of both systolic and diastolic function in the survivors of HL might be useful in the follow-up of these patients.
authors.affiliation: Department of Pediatrics, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, Turkey. dalehan@hacettepe.edu.tr
authors.forename: Dursun
authors.initials: D
authors.lastname: Alehan
authors.forename: Murat
authors.initials: M
authors.lastname: Sahin
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.forename: Işıl
authors.initials: I
authors.lastname: Yıldırım
authors.forename: Serhan
authors.initials: S
authors.lastname: Küpeli
authors.forename: Münevver
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors; D013599:Systole / Q000502:physiology*; D055815:Young Adult