Decrease of Cardiac Base Rotation in 2D Speckle Tracking Indicates Drug-induced Cardiomyopathy After Chemotherapy in Children With Cancer.
Drug-induced cardiomyopathy can be life-threatening in patients with cancer. Our objective was to explore early detection of drug-induced cardiomyopathy in children with cancer. We enrolled pediatric outpatients diagnosed with cancer between 2012 and 2013. In addition, we recruited pediatric outpatients in good general condition without cardiac disease or cancer, as controls. We measured the serum levels of biomarkers and performed chest radiography, electrocardiography, and ultrasound cardiography (UCG). We analyzed left ventricular (LV) torsion and torsion-related parameters using 2-dimensional (2D) speckle tracking on UCG. In total, 35 pediatric patients were enrolled. All patients showed negative findings for plasma troponin T, radiography, and electrocardiography. During 2D speckle tracking, 9 patients were excluded due to inappropriate dynamic echo images. We compared UCG findings between 26 patients and 16 controls. Although there was no difference in ejection fraction between patients and controls, peak LV torsion tended to be lower in patients than in controls, and the absolute basal rotation value at the timing of peak LV torsion was significantly lower in patients than in controls. In conclusion, a decrease of basal rotation in 2D speckle tracking might indicate the initial changes leading to myocardial disorder after chemotherapy.
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima Prefecture, Japan.
Kosuke
K
Yanagimoto
Yasuhiro
Y
Okamoto
Yuichi
Y
Kodama
Takuro
T
Nishikawa
Takayuki
T
Tanabe
Yoshifumi
Y
Kawano
D000293:Adolescent; D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers; D016026:Bone Marrow Transplantation; D009202:Cardiomyopathies / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D002648:Child; D002908:Chronic Disease; D003520:Cyclophosphamide / Q000009:adverse effects*; D042241:Early Diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D060046:Maintenance Chemotherapy / Q000009:adverse effects; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009369:Neoplasms / Q000188:drug therapy* / Q000628:therapy; D010446:Peptide Fragments / Q000097:blood; D013902:Radiography, Thoracic; D012399:Rotation; D013318:Stroke Volume; D020107:Troponin T / Q000097:blood
D018943:Anthracyclines; D000970:Antineoplastic Agents; D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003520:Cyclophosphamide