title: Cardiac magnetic resonance imaging in the evaluation of the late effects of anthracyclines among long-term survivors of childhood cancer.
abstract: OBJECTIVE
  This study sought to examine the left ventricular (LV) and right ventricular (RV) function and signs of focal fibrosis among long-term survivors of childhood cancer with the use of cardiac magnetic resonance (CMR) imaging.
  
  
  BACKGROUND
  Increased myocardial fibrosis has been detected in the endomyocardial biopsies of survivors. CMR has established its role in the assessment of both cardiac function and structure, and focal fibrosis of the myocardium is detectable with late gadolinium enhancement (LGE).
  
  
  METHODS
  Sixty-two anthracycline-exposed long-term survivors of childhood cancer were studied at a mean age of 14.6 years. The LV and RV ejection fractions (EFs) and volumes were measured, and LGE was assessed using CMR.
  
  
  RESULTS
  An abnormal LV function (EF <45%) was detected in 18% (11 of 62) of the survivors, and an abnormal RV function was detected in 27% (17 of 62) of the survivors. Subnormal (45% ≤ EF <55%) LV function were demonstrated in 61% (38 of 62) and subnormal RV function in 53% (33 of 62) of the survivors, respectively. Both the LV and RV end-systolic and LV end-diastolic volumes were increased compared with reference values. None of the study patients showed LGE.
  
  
  CONCLUSIONS
  A considerable proportion of the long-term survivors of childhood cancer with anthracycline exposure demonstrate signs of cardiac dysfunction detectable by CMR, with the RV also being involved. Yet, myocardial fibrosis does not seem to be detectable at a median of 7.8 years after anthracycline therapy.
authors.affiliation: Department of Pediatrics, Tampere University and the University Hospital, Tampere, Finland. kaisa@ylanen.fi
authors.forename: Kaisa
authors.initials: K
authors.lastname: Ylänen
authors.forename: Tuija
authors.initials: T
authors.lastname: Poutanen
authors.forename: Päivi
authors.initials: P
authors.lastname: Savikurki-Heikkilä
authors.forename: Irina
authors.initials: I
authors.lastname: Rinta-Kiikka
authors.forename: Anneli
authors.initials: A
authors.lastname: Eerola
authors.forename: Kim
authors.initials: K
authors.lastname: Vettenranta
mesh_terms: D000293:Adolescent; D000367:Age Factors; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005355:Fibrosis / Q000139:chemically induced / Q000473:pathology; D005387:Finland; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D015996:Survival Rate; D017741:Survivors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality; D018497:Ventricular Dysfunction, Right / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality
chemical_list: D018943:Anthracyclines