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Association between right ventricular dysfunction and restrictive lung disease in childhood cancer survivors as measured by quantitative echocardiography

Patel, Amee; Weismann, Constance LU ; Weiss, Pnina; Russell, Kerry; Bazzy-Asaad, Alia and Kadan-Lottick, Nina S (2014) In Pediatric Blood & Cancer 61(11). p.64-2059
Abstract

BACKGROUND: Restrictive lung disease is a complication in childhood cancer survivors who received lung-toxic chemotherapy and/or thoracic radiation. Left ventricular dysfunction is documented in these survivors, but less is known about right ventricular (RV) function. Quantitative echocardiography may help detect subclinical RV dysfunction. The aim of this study was to assess RV function quantitatively in childhood cancer survivors after lung-toxic therapy.

PROCEDURES: We identified records of 33 childhood cancer survivors who (1) were treated with lung-toxic therapy and/or radiation, (2) were cancer-free for ≥ one year after therapy, and (3) had pulmonary function tests and echocardiograms from their most recent follow-up... (More)

BACKGROUND: Restrictive lung disease is a complication in childhood cancer survivors who received lung-toxic chemotherapy and/or thoracic radiation. Left ventricular dysfunction is documented in these survivors, but less is known about right ventricular (RV) function. Quantitative echocardiography may help detect subclinical RV dysfunction. The aim of this study was to assess RV function quantitatively in childhood cancer survivors after lung-toxic therapy.

PROCEDURES: We identified records of 33 childhood cancer survivors who (1) were treated with lung-toxic therapy and/or radiation, (2) were cancer-free for ≥ one year after therapy, and (3) had pulmonary function tests and echocardiograms from their most recent follow-up visit.

RESULTS: Participants' mean age was 11.6 ± 4.5 years at cancer diagnosis and 23 ± 8.6 years at evaluation. The most common diagnosis was lymphoma/leukemia (n = 27). Twenty-nine subjects had anthracycline exposure. Eleven of the 33 subjects demonstrated restrictive pulmonary impairment (total lung capacity 3.69 ± 1.5 L [69.3 ± 22.4% predicted]). Among quantitative measures of RV function, isovolumetric acceleration (IVA), a measure of contractility, was significantly lower in the group with restrictive lung disease (2.42 ± 0.56 vs. 1.83 ± 0.78 m/sec(2); P < 0.05). There was a trend towards lower tissue Doppler derived S' and tricuspid annular plane systolic excursion in the group with restrictive lung disease. Subjects with restrictive lung disease were found to have ≥ 2 abnormal parameters (P < 0.01).

CONCLUSION: IVA may detect early RV dysfunction in childhood cancer survivors with restrictive lung disease. Our findings require confirmation in a larger study population and validation by cardiac MRI.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Child, Child, Preschool, Echocardiography/methods, Female, Humans, Lung Diseases/diagnostic imaging, Male, Myocardial Contraction, Neoplasms/mortality, Survivors, Ventricular Dysfunction, Right/diagnostic imaging
in
Pediatric Blood & Cancer
volume
61
issue
11
pages
64 - 2059
publisher
John Wiley and Sons Inc.
external identifiers
  • scopus:84922653942
ISSN
1545-5017
DOI
10.1002/pbc.25157
language
English
LU publication?
no
id
f19eb6d3-5fe2-467c-8231-84081c2482fc
date added to LUP
2019-01-25 14:44:41
date last changed
2019-02-20 11:44:33
@article{f19eb6d3-5fe2-467c-8231-84081c2482fc,
  abstract     = {<p>BACKGROUND: Restrictive lung disease is a complication in childhood cancer survivors who received lung-toxic chemotherapy and/or thoracic radiation. Left ventricular dysfunction is documented in these survivors, but less is known about right ventricular (RV) function. Quantitative echocardiography may help detect subclinical RV dysfunction. The aim of this study was to assess RV function quantitatively in childhood cancer survivors after lung-toxic therapy.</p><p>PROCEDURES: We identified records of 33 childhood cancer survivors who (1) were treated with lung-toxic therapy and/or radiation, (2) were cancer-free for ≥ one year after therapy, and (3) had pulmonary function tests and echocardiograms from their most recent follow-up visit.</p><p>RESULTS: Participants' mean age was 11.6 ± 4.5 years at cancer diagnosis and 23 ± 8.6 years at evaluation. The most common diagnosis was lymphoma/leukemia (n = 27). Twenty-nine subjects had anthracycline exposure. Eleven of the 33 subjects demonstrated restrictive pulmonary impairment (total lung capacity 3.69 ± 1.5 L [69.3 ± 22.4% predicted]). Among quantitative measures of RV function, isovolumetric acceleration (IVA), a measure of contractility, was significantly lower in the group with restrictive lung disease (2.42 ± 0.56 vs. 1.83 ± 0.78 m/sec(2); P &lt; 0.05). There was a trend towards lower tissue Doppler derived S' and tricuspid annular plane systolic excursion in the group with restrictive lung disease. Subjects with restrictive lung disease were found to have ≥ 2 abnormal parameters (P &lt; 0.01).</p><p>CONCLUSION: IVA may detect early RV dysfunction in childhood cancer survivors with restrictive lung disease. Our findings require confirmation in a larger study population and validation by cardiac MRI.</p>},
  author       = {Patel, Amee and Weismann, Constance and Weiss, Pnina and Russell, Kerry and Bazzy-Asaad, Alia and Kadan-Lottick, Nina S},
  issn         = {1545-5017},
  keyword      = {Adolescent,Adult,Child,Child, Preschool,Echocardiography/methods,Female,Humans,Lung Diseases/diagnostic imaging,Male,Myocardial Contraction,Neoplasms/mortality,Survivors,Ventricular Dysfunction, Right/diagnostic imaging},
  language     = {eng},
  number       = {11},
  pages        = {64--2059},
  publisher    = {John Wiley and Sons Inc.},
  series       = {Pediatric Blood & Cancer},
  title        = {Association between right ventricular dysfunction and restrictive lung disease in childhood cancer survivors as measured by quantitative echocardiography},
  url          = {http://dx.doi.org/10.1002/pbc.25157},
  volume       = {61},
  year         = {2014},
}