title: Feasibility of Echocardiographic Techniques to Detect Subclinical Cancer Therapeutics-Related Cardiac Dysfunction among High-Dose Patients When Compared with Cardiac Magnetic Resonance Imaging.
abstract: BACKGROUND
  Cardiac magnetic resonance imaging (CMR) is the gold standard for the quantification of global and regional myocardial function and can detect subclinical myocardial dysfunction in anthracycline-induced cardiomyopathy. The aim of this study was to ascertain reliable echocardiographic parameters that can be used for the early identification of cancer therapeutics-related cardiac dysfunction, compared with CMR.
  
  
  METHODS
  Fifty-seven pediatric cancer survivors, 10 to 42 years of age, with cumulative anthracycline doses ≥ 200 mg/m(2), were studied with transthoracic echocardiography and CMR 2.4 to 26.9 years after chemotherapy.
  
  
  RESULTS
  Three-dimensional echocardiography had the highest sensitivity in identifying subjects with CMR-derived ejection fractions < 55%. Subjects with end-systolic volume index values > 29 mL/m(2) were more likely to have CMR-derived ejection fractions < 55%. Three-dimensional speckle-tracking echocardiographic peak global longitudinal strain magnitude < -17.5% best identified subjects with abnormal peak midwall longitudinal strain magnitude by CMR. A decrease in early atrial myocardial velocity of <10 cm/sec at the interventricular septum also identified subjects with lower average peak midwall longitudinal strain and peak midwall circumferential strain magnitudes by CMR.
  
  
  CONCLUSIONS
  Three-dimensional echocardiographic ejection fraction < 55%, end-systolic volume index > 29 mL/m(2), three-dimensional speckle-tracking echocardiographic peak global longitudinal strain magnitude < -17.5%, and a decrease in early atrial myocardial velocity at the interventricular septum of <10 cm/sec by Doppler tissue imaging are the most sensitive transthoracic echocardiographic parameters to identify subjects with subclinical myocardial dysfunction by CMR.
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut; Hartford Hospital, Hartford, Connecticut. Electronic address: otoro@connecticutchildrens.org.
authors.forename: Olga H
authors.initials: OH
authors.lastname: Toro-Salazar
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut.
authors.forename: Joanna
authors.initials: J
authors.lastname: Ferranti
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut; Montefiore Medical Center, Bronx, New York.
authors.forename: Raymond
authors.initials: R
authors.lastname: Lorenzoni
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut.
authors.forename: Steven
authors.initials: S
authors.lastname: Walling
authors.affiliation: The Heart and Vascular Center, The Christ Hospital, Cincinnati, Ohio.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Mazur
authors.affiliation: The Ohio State University Medical Center, Columbus, Ohio.
authors.forename: Subha V
authors.initials: SV
authors.lastname: Raman
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut.
authors.forename: Brooke T
authors.initials: BT
authors.lastname: Davey
authors.affiliation: Connecticut Children's Medical Center, Hartford, Connecticut.
authors.forename: Eileen
authors.initials: E
authors.lastname: Gillan
authors.affiliation: Hartford Hospital, Hartford, Connecticut.
authors.forename: Michael
authors.initials: M
authors.lastname: O'Loughlin
authors.affiliation: TomTec Corporation, Chicago, Illinois.
authors.forename: Berthold
authors.initials: B
authors.lastname: Klas
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Kan N
authors.initials: KN
authors.lastname: Hor
mesh_terms: D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents
keywords: Anthracyclines; Cardiotoxicity; Cardiovascular imaging agents/techniques; Echocardiography; Myocardial strain