Document Detail

Subclinical cardiac dysfunction and exercise performance in childhood cancer survivors.
MedLine Citation:
PMID:  21058389     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although anthracycline cardiotoxicity is clearly related to the cumulative dose administered, subclinical cardiac dysfunction has been reported across a wide range of treatment regimens, and its clinical significance is still unclear. Purpose of this study is to investigate by exercise echocardiography for subclinical cardiac dysfunction in survivors of pediatric cancer treated with low-moderate anthracycline doses, and to evaluate whether it may alter the response of the cardiovascular system to dynamic exercise.
PROCEDURE: Post-exercise left ventricular end-systolic wall stress (ESS), left ventricular posterior wall dimension and percent thickening at end systole, and cardiopulmonary exercise test-derived indexes of cardiac function were examined in 55 apparently healthy patients (mean age 13.5 ± 2.9 years, median anthracycline cumulative dose 240 mg/m(2)) and in 63 controls.
RESULTS: Subclinical cardiac dysfunction was identified in 17 patients (30%) presenting reduced left ventricular posterior wall dimension or percent thickening, or increased values of left ventricular ESS as compared to controls (group A), while the remaining patients formed group B. Reduced oxygen consumption at peak exercise in both groups of patients was the only cardiopulmonary exercise test variable resulting significantly different between patients and controls: no differences were found among the groups of patients.
CONCLUSIONS: Our results confirm that even patients treated with a median anthracycline dose of 240 mg/m(2) (range 100-490) are at considerable risk of exhibiting subclinical cardiac dysfunction that, however, does not seem to alter the physiologic response of the cardiovascular system to dynamic exercise.
Enrico De Caro; Attilio Smeraldi; Gianluca Trocchio; Mariagrazia Calevo; Guia Hanau; Giacomo Pongiglione
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  56     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-11-25     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  122-6     Citation Subset:  IM    
Department of Cardiology, Giannina Gaslini Children's Hospital, Genova, Italy.
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MeSH Terms
Anthracyclines / adverse effects*
Case-Control Studies
Child, Preschool
Echocardiography, Stress
Exercise Test / drug effects*
Heart Diseases / chemically induced*,  physiopathology
Neoplasms / complications,  drug therapy*,  physiopathology*
Oxygen Consumption / drug effects
Ventricular Dysfunction, Left / chemically induced
Reg. No./Substance:

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