Use of speckle tracking echocardiography to detect late anthracycline-induced cardiotoxicity in childhood cancer: A prospective controlled cross-sectional study

Pascal Amedro (1, 2) , Marie Vincenti (3, 4) , Hamouda Abassi (4) , Nicolas Lanot (4) , Gregoire de La Villeon (4) , Sophie Guillaumont (4) , Lucie Gamon (5) , Thibault Mura (5) , Karine Lopez-Perrin (4) , Stephany Haouy (4) , Anne Sirvent (4) , Olivier Cazorla (4, 3) , Laurence Vergely (4) , Alain Lacampagne (3, 4) , Martina Avesani (2) , Nicolas Sirvent (4) , Laure Saumet (4)

1 IHU-LIRYC
2 CHU Bordeaux
3 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
4 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
5 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes

Background: This study aimed to detect late sub-clinical patterns of cardiac dysfunction using speckle tracking echocardiography (STE) in children with cancer remission more than 12 months after the end of anthracycline treatment. Methods: This prospective controlled study enrolled 196 children, 98 of which had been treated with anthracyclines (mean age 10.8 ± 3.6 years; 51% female) and 98 were age- and gender-matched healthy subjects in a 1:1 case-control design. Conventional echocardiographic variables were collected for left ventricle (LV) and right ventricle (RV). STE analyses were performed in the LV longitudinal, radial, and circumferential displacements and in the RV free wall longitudinal displacement. The association between LV global longitudinal strain (GLS) and the main clinical and biological parameters was evaluated. Results: After a mean time interval of 5.1 ± 3.2 years since the end of chemotherapy (mean cumulative anthracycline dose of 192 ± 96 mg/m2), conventional echocardiographic measures were normal. GLS was significantly decreased in the anthracycline group (-19.1% vs. -21.5%, P < 0.0001), with a higher proportion of children with abnormal values (Z-score < -2 in 18.6% vs. 1.0%, P < 0.0001). No association was found between GLS and clinical or biological parameters. Circumferential strain was significantly worse in the anthracycline group (-16.8% vs. -19.4%, P < 0.0001), and radial strain significantly better (+51.4% vs. +35.9%, P < 0.0001). RV conventional echocardiography and STE parameters were normal and not different between anthracycline and control groups. Conclusions: The existence of a modified LV strain despite normal LV function in children treated with anthracyclines represents an important perspective for cardiomyopathy surveillance in childhood cancer survivors. Clinical Trial Registration -ClinicalTrials.gov Identifier: NCT02893787.

Mots clés: 2D strain; Cardiomyopathy; Chemotherapy; Echocardiography; Heart failure; Paediatrics

Domaines: Sciences du Vivant [q-bio]

Pascal Amedro, Marie Vincenti, Hamouda Abassi, Nicolas Lanot, Gregoire de La Villeon, et al.. Use of speckle tracking echocardiography to detect late anthracycline-induced cardiotoxicity in childhood cancer: A prospective controlled cross-sectional study. International Journal of Cardiology, 2022, 354, pp.P 75-83. ⟨10.1016/j.ijcard.2022.02.012⟩. ⟨hal-03576808⟩