Subclinical reduction in left ventricular function using triplane and 2D speckle tracking echocardiography after anthracycline exposure in children

• Published in: Anatolian journal of cardiology Vol. 19; no. 1; pp. 58 - 66
• Main Authors: Çilsal, Erman, Oğuz, Ayşe Deniz, Tunaoğlu, Fatma Sedef, Kula, Serdar, Pektaş, Ayhan
• Format: Journal Article
• Language: English
• Published: Turkey Kare Publishing 01-01-2018
• Subjects: Original Investigation; Patients
• ISSN: 2149-2263; 2149-2271
• DOI: 10.14744/AnatolJCardiol.2017.7944

Speckle tracking echocardiography (STE) enables global and regional evaluation of the left ventricle (LV); therefore, it is the most useful method for detecting subclinical dysfunction in patients exposed to cardiotoxic agents. A novel technique triplane (3P) echocardiography also allows single beat assessment of LV global longitudinal strain values. We firstly aimed to demonstrate both two-dimensional (2D)- and 3PSTE-derived LV global longitudinal strain measurements in children after anthracycline exposure.
This study included 23 cross-sectionally enrolled asymptomatic pediatric cancer patients who received anthracycline chemotherapy and 17 healthy controls matched by age, gender, and body surface area. All subjects underwent detailed 2D, Doppler, 2D-STE, and 3P-STE for assessment of LV function. The patients had received a median cumulative dose of 150 mg/m
.
1. From "Pulsed" Doppler-based measurements, only pulmonary vein flow ratio showed a significant difference between the groups. 2. When measurements were taken from the interventricular septum, the patients' ejection time values decreased significantly and their myocardial performance index values increased significantly; when the measurements were taken from the LV free wall, the peak systolic velocities showed a statistically significant difference. 3. Both 2D- and 3P-STE-derived longitudinal myocardial deformation values of LV were lower in the patient group. 4. 2D-STE-derived LV circumferential strain values were decreased in the patient group, whereas radial strain values were not significantly different compared with matched controls.
Using Doppler and 2D- and 3P-STE methods, this study confirmed the subclinical LV dysfunction in patients after anthracycline exposure.