Echocardiographic evaluation of patients cured of childhood cancer: A single center study of 117 subjects who received anthracyclines

Background. The risk of cardiomyopathy following exposure to anthracycline in asymptomatic long-term survivors oi childhood cancer is still hard to pr edict and precisely quantify. To identify the impact of different cumulativ e doses, even within a non-high dose range, and the echocardiographic param eters suitable for evaluating cardiac function, Lye studied diastolic and s ystolic echocardiographic parameters in a cohort of patients followed in a single center. Procedure. A total of 117 subjects were studied at a median time of 7 years after treatment completion. A complete M-mode, two-dimensio nal and Doppler echocardiographic study was obtained at rest in ail patient s according to the standard recommendations of the American Society of Echo cardiography. Results. Ninety-nine patients (85%) had completely normal car diac function, while 18 had abnormal echocardiographic findings: 12 had one abnormal value, 5 had two, and 1 had three abnormal values. All the change s were in left ventricular dimensions, wall thickness or indices of systoli c function; no alterations in left ventricular diastolic function parameter s were found. None of the echocardiographic parameters correlated significa ntly with the cumulative dose of anthracyclines administered either at univ ariate analysis or after adjusting for sex, body surface area or considered risk factors. Conclusions. Subjects exposed to a median cumulative dose of 214 mg/m(2) had no echographic abnormalities a median of 7 years later. We did not find any correlation between cumulative anthracycline dose and the echocardiographic parameters tested. We now offer echocardiographic follow -up to patients with mildly reduced fractional shortening and/or ejection f raction to rule out late onset dysfunction. (C) 2001 Wiley-Liss, Inc.