A longitudinal study of cardiac function in children with cancer over 40 months

A previous study demonstrated impaired systolic function in 29% of patients treated with anthracycline as part of their therapy for malignant disease. A follow-up echocardiographic study was performed to determine whether the re had been further deterioration of cardiac function. At least 40 months a fter the first study, those patients In whom abnormal systolic function had been detected and who had not received further anthracycline were studied by echocardiography using the same protocol as the initial study (group A). A second group of pediatric oncology patients who had not been given anthr acycline but who had previously had cardiac assessment was selected as a co ntrol group (group N). The age and sex distributions of the two groups were comparable. Group A comprised 29 patients assessed on 2 occasions at mean times of 46 months and 89 months from the last dose of anthracycline. The m ean dose of anthracycline received was 233 mg/m(2) (range 20-400). Nine of 16 patients and 4 of 5 patients who had abnormal ejection fraction (EF) and fractional shortening (FS) at first assessment had normal EF and FS at the second assessment. There were no significant changes in EF, FS, and left v entricular wall stress (LVWS) between the two examinations. In group N, 20 patients were assessed after a mean interval of 43 months. There were no si gnificant changes in EF FS, or LVWS between the two examinations. At the fi rst but not the second examination there were significant differences in th e left ventricular internal diameters, EF, FS, and LVWS between group A and group N. Mildly abnormal cardiac indices detected in child? en after cessa tion of treatment with anthracycline did riot deteriorate in 3 to 4 years f ollow-up. ii longer cardiac follow-up study is indicated to assess the late outcome.