Anthracycline-induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post-lymphoma remission.
anthracycline
childhood lymphoma survivors
intraventricular mechanical dispersion
myocardial work
regional myocardial function
speckle tracking echocardiography
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
10 Jan 2024
10 Jan 2024
Historique:
revised:
28
11
2023
received:
31
08
2023
accepted:
10
12
2023
medline:
11
1
2024
pubmed:
11
1
2024
entrez:
11
1
2024
Statut:
aheadofprint
Résumé
Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in childhood lymphoma survivors (CLS). Thirty-one young adults including CLS and age-matched healthy controls were enrolled. All underwent echocardiography including an evaluation of left ventricular (LV) morphology and regional function. We assessed LV longitudinal (differentiating sub-endocardial and sub-epicardial layers), circumferential strains and twist, global and regional MW index (MWI). LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain, from myocardial wasted work (MWW) and myocardial work efficiency (MWE). The longitudinal strains both at the level of the sub-endocardium and sub-epicardium were reduced in CLS compared to controls. The global MWI was also decreased (1668 ± 266 vs 1870 ± 264%.mmHg in CLS patients and controls, respectively, p < 0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. MWW and MWE remained unchanged compared to controls. Our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in MW and an increase in LV mechanical dispersion. The apex is specifically altered, but its clinical significance remains uncertain. MW as a complement to strain seems interesting in cancer survivors to detect myocardial dysfunction at early stage and adapt their follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in childhood lymphoma survivors (CLS).
METHODS
METHODS
Thirty-one young adults including CLS and age-matched healthy controls were enrolled. All underwent echocardiography including an evaluation of left ventricular (LV) morphology and regional function. We assessed LV longitudinal (differentiating sub-endocardial and sub-epicardial layers), circumferential strains and twist, global and regional MW index (MWI). LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain, from myocardial wasted work (MWW) and myocardial work efficiency (MWE).
RESULTS
RESULTS
The longitudinal strains both at the level of the sub-endocardium and sub-epicardium were reduced in CLS compared to controls. The global MWI was also decreased (1668 ± 266 vs 1870 ± 264%.mmHg in CLS patients and controls, respectively, p < 0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. MWW and MWE remained unchanged compared to controls.
CONCLUSION
CONCLUSIONS
Our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in MW and an increase in LV mechanical dispersion. The apex is specifically altered, but its clinical significance remains uncertain. MW as a complement to strain seems interesting in cancer survivors to detect myocardial dysfunction at early stage and adapt their follow-up.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
Steliarova-Foucher E, Colombet M, Ries LAG, et al. International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol. 2017 Jun;18(6):719-731.
Erdmann F, Frederiksen LE, Bonaventure A, et al. Childhood cancer: survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol. 2021 Apr;1(71):101733.
Franco VI, Lipshultz SE. Cardiac complications in childhood cancer survivors treated with anthracyclines. Cardiol Young. 2015;25(S2):107-116.
Mulrooney DA, Yeazel MW, Kawashima T, et al. Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the childhood cancer survivor study cohort. BMJ. 2009;8(339):b4606.
Steinherz LJ, Steinherz PG, Tan C. Cardiac failure and dysrhythmias 6-19 years after anthracycline therapy: a series of 15 patients. Med Pediatr Oncol. 1995;24(6):352-361.
Lima MAC, Brito HRA, Mitidieri GG, et al. Cardiotoxicity in cancer patients treated with chemotherapy: a systematic review. Int J Health Sci (Qassim). 2022;16(6):39-46.
Bloom MW, Hamo CE, Cardinale D, et al. Cancer therapy-related cardiac dysfunction and heart failure. Circulation: Heart Failure. 2016;9(1):e002661.
Tarantini L, Gulizia MM, Di Lenarda A, et al. ANMCO/AIOM/AICO consensus document on clinical and management pathways of cardio-oncology: executive summary. Eur Heart J Suppl. 2017;19(Suppl D):D370-D379.
Čelutkienė J, Pudil R, López-Fernández T, et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the heart failure association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the cardio-oncology Council of the European Society of cardiology (ESC). Eur J Heart Fail. 2020;22(9):1504-1524.
Plana JC, Galderisi M, Barac A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2014;27(9):911-939.
Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH. Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy. J Am Coll Cardiol. 2014;63(25):2751-2768.
Biswas M, Sudhakar S, Nanda NC, et al. Two- and three-dimensional speckle tracking echocardiography: clinical applications and future directions. Echocardiography. 2013;30(1):88-105.
Padmanabhan S, Singh S, Nanda CN. Speckle tracking echocardiography: clinical usefulness. Comprehensive Textbook of Echocardiography. 2014th ed. Jaypee Brothers Medical Publishers; 2014:360-379.
Yu AF, Raikhelkar J, Zabor EC, et al. Two-dimensional speckle tracking echocardiography detects subclinical left ventricular systolic dysfunction among adult survivors of childhood, adolescent, and young adult cancer. BioMed Res Int. 2016;2016:1-8.
Merkx R, Leerink JM, de Baat EC, et al. Asymptomatic systolic dysfunction on contemporary echocardiography in anthracycline-treated long-term childhood cancer survivors: a systematic review. J Cancer Surviv. 2022;16(2):338-352.
Amedro P, Vincenti M, Abassi H, et al. Use of speckle tracking echocardiography to detect late anthracycline-induced cardiotoxicity in childhood cancer: a prospective controlled cross-sectional study. Int J Cardiol. 2022;354:75-83.
Cheung Y, Li SN, Chan GC, Wong SJ, Ha SY. Left ventricular twisting and untwisting motion in childhood cancer survivors: LV twist in childhood cancer survivors. Echocardiography. 2011 Aug;28(7):738-745.
Slieker MG, Fackoury C, Slorach C, et al. Echocardiographic assessment of cardiac function in pediatric survivors of anthracycline-treated childhood cancer. Circ. Cardiovasc Imag. 2019;12(12):e008869.
Paysal J, Merlin E, Terral D, et al. Left ventricular strains and myocardial work in adolescents with anorexia nervosa. Front Cardiovasc Med. 2022;8(9):798774.
Potter E, Marwick TH. Assessment of left ventricular function by echocardiography: the case for routinely adding global longitudinal strain to ejection fraction. JACC Cardiovasc Imaging. 2018;11(2 Pt 1):260-274.
Li X, Zhang P, Li M, Zhang M. Myocardial work: the analytical methodology and clinical utilities. Hellenic J Cardiol. 2022;68:46-59.
Ilardi F, D'Andrea A, D'Ascenzi F, et al. Myocardial work by echocardiography: principles and applications in clinical practice. JCM. 2021;10(19):4521.
Birat A, Ratel S, Dodu A, et al. A long-duration race induces a decrease of left ventricular strains, twisting mechanics and myocardial work in trained adolescents. Euro J Sport Sci. 2023;23(7):1394-1404.
Russell K, Eriksen M, Aaberge L, et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work. European Heart J. 2012;33(6):724-733.
Russell K, Eriksen M, Aaberge L, et al. Assessment of wasted myocardial work: a novel method to quantify energy loss due to uncoordinated left ventricular contractions. Am J PhyHeart and Circ Physiol. 2013;305(7):H996-H1003.
Edwards NFA, Scalia GM, Shiino K, et al. Global myocardial work is superior to global longitudinal strain to predict significant coronary artery disease in patients with Normal left ventricular function and wall motion. J Am Society Echocardiography. 2019;32(8):947-957.
Sawyer DB, Peng X, Chen B, Pentassuglia L, Lim CC. Mechanisms of anthracycline cardiac injury: can we identify strategies for cardio-protection? Progress in Cardiovascular Diseases. 2010;53(2):105-113.
Tham EB, Haykowsky MJ, Chow K, et al. Diffuse myocardial fibrosis by T1-mapping in children with subclinical anthracycline cardiotoxicity: relationship to exercise capacity, cumulative dose and remodeling. J Cardiovasc Magn Reson. 2013;15(1):48.
Harbo MB, Stokke MK, Sjaastad I, Espe EKS. One step closer to myocardial physiology: from PV loop analysis to state-of-the-art myocardial imaging. Acta Physiologica. 2022;234(2):e13759.
Armand A, Rochette E, Grèze V, et al. Fitness and metabolic response to exercise in young adult survivors of childhood lymphoma. Support Care Cancer. 2023;31(6):358.
Grandperrin A, Schuster I, Moronval P, et al. Anabolic steroids use is associated with impairments in atrial and ventricular cardiac structure and performance in athletes. Med Sci Sports & Exer. 2022;54(5):780-788.
Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Society Echocardiography. 2015;28(1):1-39.e14.
Wang J, Khoury DS, Thohan V, Torre-Amione G, Nagueh SF. Global diastolic strain rate for the assessment of left ventricular relaxation and filling pressures. Circulation. 2007;115(11):1376-1383.
Notomi Y, Lysyansky P, Setser RM, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol. 2005;45(12):2034-2041.
Çetin S, Babaoğlu K, Başar EZ, Deveci M, Çorapçıoğlu F. Subclinical anthracycline-induced cardiotoxicity in long-term follow-up of asymptomatic childhood cancer survivors: assessment by speckle tracking echocardiography. Echocardiography. 2018;35(2):234-240.
Sun JP, Xu TY, Ni XD, et al. Echocardiographic strain in hypertrophic cardiomyopathy and hypertensive left ventricular hypertrophy. Echocardiography. 2019;36(2):257-265.
Ylänen K, Poutanen T, Savikurki-Heikkilä P, Rinta-Kiikka I, Eerola A, Vettenranta K. Cardiac magnetic resonance imaging in the evaluation of the late effects of anthracyclines among Long-term survivors of childhood cancer. J Am College Cardiol. 2013;61(14):1539-1547.
Sengupta PP, Tajik AJ, Chandrasekaran K, Khandheria BK. Twist mechanics of the left ventricle: principles and application. JACC Cardiovasc Imaging. 2008;1(3):366-376.
Yu W, Li SN, Chan GC, Ha SY, Wong SJ, Cheung YF. Transmural strain and rotation gradient in survivors of childhood cancers. Euro Heart J Cardiovasc Imag. 2013;14(2):175-182.
Abawi D, Rinaldi T, Faragli A, et al. The non-invasive assessment of myocardial work by pressure-strain analysis: clinical applications. Heart Fail Rev. 2022;27(4):1261-1279.
Gao L, Wang Y, Gao M, Chen L. Clinical research progress of myocardial work in assessment and prediction of coronary artery disease in noninvasive pressure-strain loop technique. J of Clinical Ultrasound. 2023;51(1):38-45.
Zhan J, Van den Eynde J, Cordrey K, et al. Deterioration in myocardial work indices precedes changes in global longitudinal strain following anthracycline chemotherapy. Int J Cardiol. 2022;15(363):171-178.
Mihalcea D, Memis H, Balinisteanu A, Vladareanu A, Mihaila S, Vinereanu D. Myocardial work-a new tool for early detection of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone chemotherapy induced-cardiotoxicity in hematological patients. J of Clinical Ultrasound. 2022;51:377-384.
Zhan J, Van den Eynde J, Ozdemir E, et al. Left ventricular myocardial work indices in pediatric hypertension: correlations with conventional echocardiographic assessment and subphenotyping. Eur J Pediatr. 2022;181(7):2643-2654.
Poterucha JT, Kutty S, Lindquist RK, Li L, Eidem BW. Changes in left ventricular longitudinal strain with anthracycline chemotherapy in adolescents precede subsequent decreased left ventricular ejection fraction. J Am Soc Echocardiogr. 2012;25(7):733-740.
Okuma H, Noto N, Tanikawa S, et al. Impact of persistent left ventricular regional wall motion abnormalities in childhood cancer survivors after anthracycline therapy: assessment of global left ventricular myocardial performance by 3D speckle-tracking echocardiography. Journal of Cardiology. 2017;70(4):396-401.
Yu HK, Yu W, Cheuk DK, Wong SJ, Chan GC, Cheung YF. New three-dimensional speckle-tracking echocardiography identifies global impairment of left ventricular mechanics with a high sensitivity in childhood cancer survivors. J Am Soc Echocardiogr. 2013;26(8):846-852.
Chakouri N, Farah C, Matecki S, et al. Screening for in-vivo regional contractile defaults to predict the delayed doxorubicin cardiotoxicity in juvenile rat. Theranostics. 2020;10(18):8130-8142.
Buckberg G, Nanda CN, Hoffman JI, Coghlan C. Newer aspects of structure/function to assess cardiac motion. Comprehensive Textbook of Echocardiography. 2014th ed. Jaypee Brothers Medical Publishers; 2014:1176-1209.
Bernaba BN, Chan JB, Lai CK, Fishbein MC. Pathology of late-onset anthracycline cardiomyopathy. Cardiovasc Pathol. 2010;19(5):308-311.
Leerink JM, de Baat EC, Feijen EAM, et al. Cardiac disease in childhood cancer survivors. JACC: CardioOncology. 2020;2(3):363-378.
Cheung Y, Hong WJ, Chan GC, Wong SJ, Ha SY. Left ventricular myocardial deformation and mechanical dyssynchrony in children with normal ventricular shortening fraction after anthracycline therapy. Heart. 2010;96(14):1137-1141.
Klitsie LM, Roest AAW, Van der Hulst AE, Stijnen T, Blom NA, Adj H. Assessment of intraventricular time differences in healthy children using two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr. 2013;26(6):629-639.