Ecocardiografia durante sforzo isometrico in pazienti sopravvissuti a lungo termine ad una neoplasis dell'infanzia, trattati con radio e chemioterapia

Translated title of the contribution: Title needs translated

C. Materazzo, P. Piotti, L. Rottoli, M. Stefanelli, R. Meazza, S. Biasi

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Abstract

To disclose late cardiac sequelae in asymptomatic patients treated with anthracycline and mediastinal radiotherapy an echo-stress screening test was used. Seventy-four patients (mean age 19 ± 4 years) and 13 normal age-matched control subjects underwent echocardiographic examination during isometric handgrip exercise. The patients were treated from 1 to 13 years (mean 6.9 ± 3.3 years) before the examination with 90-450 mg/m2 of doxorubicin (mean 241 ± 103 mg/m2) and 49 of them (66%) also received 24-38 Gy of radiotherapy (29-5 Gy) to a field including the heart. The major findings at rest, in the patients compared with controls, were a reduced left ventricular posterior wall thickness (1.22 ± 0.17 vs 1.36 ± 0.15 cm; p = 0.007) and a slightly lower fractional shortening (32.8 ± 4.4 vs 35.3 ± 3.4%; p = 0.06). During handgrip exercise left ventricular end-systolic wall thickness (posterior wall plus septal dimensions divided by two) adjusted for body surface area was decreased (0.75 ± 0.12 vs 0.83 ± 0.06 cm/m2; p = 0.02), end-systolic wall stress was much higher (90.2 ± 23.8 vs 69.9 ± 12.4 g/cm2; p = 0.004) and fractional shortening became more significantly reduced (32.7 ± 4.8 vs 38 ± 5%; p = 0.0001) in the patients compared with controls. No differences were found in blood pressure or heart rate both at rest and during exercise between the two groups. These results suggest that asymptomatic long-term survivors of childhood cancer treated with doxorubicin and mediastinal radiotherapy may have subtle abnormalities in cardiac performance which become more clearly delineated after isometric handgrip exercise.

Original languageItalian
Pages (from-to)327-330
Number of pages4
JournalCardiovascular Imaging
Volume8
Issue number2
Publication statusPublished - 1996

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Exercise
Radiotherapy
Doxorubicin
Body Surface Area
Anthracyclines
Exercise Test
Survivors
Heart Rate
Blood Pressure
Neoplasms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Ecocardiografia durante sforzo isometrico in pazienti sopravvissuti a lungo termine ad una neoplasis dell'infanzia, trattati con radio e chemioterapia. / Materazzo, C.; Piotti, P.; Rottoli, L.; Stefanelli, M.; Meazza, R.; Biasi, S.

In: Cardiovascular Imaging, Vol. 8, No. 2, 1996, p. 327-330.

Research output: Contribution to journalArticle

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abstract = "To disclose late cardiac sequelae in asymptomatic patients treated with anthracycline and mediastinal radiotherapy an echo-stress screening test was used. Seventy-four patients (mean age 19 ± 4 years) and 13 normal age-matched control subjects underwent echocardiographic examination during isometric handgrip exercise. The patients were treated from 1 to 13 years (mean 6.9 ± 3.3 years) before the examination with 90-450 mg/m2 of doxorubicin (mean 241 ± 103 mg/m2) and 49 of them (66{\%}) also received 24-38 Gy of radiotherapy (29-5 Gy) to a field including the heart. The major findings at rest, in the patients compared with controls, were a reduced left ventricular posterior wall thickness (1.22 ± 0.17 vs 1.36 ± 0.15 cm; p = 0.007) and a slightly lower fractional shortening (32.8 ± 4.4 vs 35.3 ± 3.4{\%}; p = 0.06). During handgrip exercise left ventricular end-systolic wall thickness (posterior wall plus septal dimensions divided by two) adjusted for body surface area was decreased (0.75 ± 0.12 vs 0.83 ± 0.06 cm/m2; p = 0.02), end-systolic wall stress was much higher (90.2 ± 23.8 vs 69.9 ± 12.4 g/cm2; p = 0.004) and fractional shortening became more significantly reduced (32.7 ± 4.8 vs 38 ± 5{\%}; p = 0.0001) in the patients compared with controls. No differences were found in blood pressure or heart rate both at rest and during exercise between the two groups. These results suggest that asymptomatic long-term survivors of childhood cancer treated with doxorubicin and mediastinal radiotherapy may have subtle abnormalities in cardiac performance which become more clearly delineated after isometric handgrip exercise.",
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