Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer.

Journal Article (Journal Article)

Two-dimensional speckle tracking echocardiography (2DSTE) provides a sensitive measure of left ventricular (LV) systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: 31.4 ± 8.8 years; 55% male; mean time since diagnosis: 15.4 ± 9.4 years) previously treated with anthracyclines (mean cumulative dose: 320 ± 124 mg/m(2)), with (n = 52) or without (n = 82) mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF) < 55%, and global longitudinal strain (GLS) ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18%) patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, p = 0.003) and prevalence of abnormal GLS was higher (36.5% versus 14.6%, p = 0.004) in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS (p = 0.040) after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors.

Full Text

Duke Authors

Cited Authors

  • Yu, AF; Raikhelkar, J; Zabor, EC; Tonorezos, ES; Moskowitz, CS; Adsuar, R; Mara, E; Huie, K; Oeffinger, KC; Steingart, RM; Liu, JE

Published Date

  • 2016

Published In

Volume / Issue

  • 2016 /

Start / End Page

  • 9363951 -

PubMed ID

  • 26942202

Pubmed Central ID

  • PMC4749762

Electronic International Standard Serial Number (EISSN)

  • 2314-6141

Digital Object Identifier (DOI)

  • 10.1155/2016/9363951


  • eng

Conference Location

  • United States