Evaluation of myocardial functions in children receiving anthracyclines.

Y. Yozgat, V. Okutan, A. Kürekçi, A. Atay, U. Karaarslan, M. Lenk, O. Özcan
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Abstract

Objective: In our study, using echocardiographic measurements, patients with acute lymphoblastic leukemia receiving anthracycline therapy have been evaluated as for the presence of anthracycline-induced cardiac dysfunction, and it has been carried out to determine the statistically significant predictive echocardiographic parameters. Methods: Thirty cases (mean age 9.87±3.92 years, 13 males and 17 females) with acute lymphoblastic leukemia receiving anthracycline therapy were enrolled in the study, along with 30 agematched controls. Their cardiac functions were evaluated echocardiographically with two dimensional, M-mode, PW Doppler and PW tissue Doppler methods. Results: Left ventricular cardiac functions were significantly reduced in the study group. The fractional shortening (FS) was 36.09±3.17 in the study group as opposed to 39.65±3.21 in controls (p=0.03). Diastolic functions (E/A ratio) weren’t significantly altered in the study group. Right ventricular (RV) flow E/A was 1.36±0.29 and 1.34±0.69, respectively (p>0.05). Left ventricular (LV) flow E/A was 1.53±0.31 and 1.58±0.35, respectively (p>0.05). Myocardial performance index (MPI) was calculated in the study subjects using both PW Doppler and PW tissue Doppler methods, and compared to controls. RV flow MPI was 0.39±0.02, and 0.33±0.03, respectively (p<0.01). LV flow MPI was 0.41±0.08 and 0.34±0.04, respectively (p<0.01). RV tissue MPI was 0.44±0.04, and 0.39±0.05, respectively (p<0.01). LV tissue MPI was 0.42±0.02 and 0.36±0.01, respectively (p<0.01). Conclusion: The results of our study show that MPI and systolic functional changes are better indicators of anthracycline cardiotoxicity than diastolic functions. We suggest that RV and LV tissue MPI be primarily used in the search for anthracycline cardiotoxicity.
接受蒽环类药物治疗的儿童心肌功能的评价。
目的:在我们的研究中,通过超声心动图测量,评估接受蒽环类药物治疗的急性淋巴细胞白血病患者是否存在蒽环类药物引起的心功能障碍,并确定具有统计学意义的预测超声心动图参数。方法:选取30例接受蒽环类药物治疗的急性淋巴细胞白血病患者(平均年龄9.87±3.92岁,男13例,女17例)和30例年龄匹配的对照组。采用二维超声心动图、m型超声心动图、PW多普勒超声心动图和PW组织多普勒超声心动图评价两组患者的心功能。结果:研究组左心室心功能明显降低。研究组的分数缩短(FS)为36.09±3.17,对照组为39.65±3.21 (p=0.03)。研究组的舒张功能(E/A比值)无明显改变。右心室血流E/A分别为1.36±0.29和1.34±0.69 (p < 0.05)。左室(LV)血流E/A分别为1.53±0.31和1.58±0.35 (p < 0.05)。采用PW多普勒和PW组织多普勒方法计算研究对象的心肌功能指数(MPI),并与对照组进行比较。RV血流MPI分别为0.39±0.02、0.33±0.03 (p<0.01)。左室血流MPI分别为0.41±0.08、0.34±0.04 (p<0.01)。RV组织MPI分别为0.44±0.04、0.39±0.05 (p<0.01)。左室组织MPI分别为0.42±0.02和0.36±0.01 (p<0.01)。结论:我们的研究结果表明MPI和收缩功能变化是蒽环类药物心脏毒性较好的指标。我们建议右室和左室组织MPI主要用于寻找蒽环类药物的心脏毒性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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