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Cardiac function in childhood cancer survivors treated with vincristine: Echocardiographic results from the DCCSS LATER 2 CARD study.
Merkx, Remy; Feijen, E Lieke A M; Leerink, Jan M; de Baat, Esmée C; Bellersen, Louise; van Dalen, Elvira C; van Dulmen-den Broeder, Eline; van der Heiden-van der Loo, Margriet; van den Heuvel-Eibrink, Marry M; de Korte, Chris L; Loonen, Jacqueline; Louwerens, Marloes; Ronckers, Cécile M; Teske, Arco J; Tissing, Wim J E; de Vries, Andrica C H; Mavinkurve-Groothuis, Annelies M C; van der Pal, Helena J H; Weijers, Gert; Kok, Wouter E M; Kremer, Leontien C M; Kapusta, Livia.
Afiliación
  • Merkx R; Department of Medical Imaging/Radiology, Medical UltraSound Imaging Centre, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands. Electronic address: Remy.Merkx@radboudumc.nl.
  • Feijen ELAM; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Leerink JM; Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • de Baat EC; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Bellersen L; Department of Cardiology, Radboud university medical center, Nijmegen, the Netherlands.
  • van Dalen EC; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • van Dulmen-den Broeder E; Department of Pediatric Oncology, Amsterdam UMC, VU University, Amsterdam, the Netherlands.
  • van der Heiden-van der Loo M; Trial- and Data Center, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • van den Heuvel-Eibrink MM; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, the Netherlands.
  • de Korte CL; Department of Medical Imaging/Radiology, Medical UltraSound Imaging Centre, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands. Electronic address: chris.dekorte@radboudumc.nl.
  • Loonen J; Department of Haematology, Radboud university medical center, Nijmegen, the Netherlands.
  • Louwerens M; Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.
  • Ronckers CM; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Teske AJ; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Tissing WJE; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • de Vries ACH; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Mavinkurve-Groothuis AMC; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • van der Pal HJH; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Weijers G; Department of Medical Imaging/Radiology, Medical UltraSound Imaging Centre, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands.
  • Kok WEM; Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Kremer LCM; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
  • Kapusta L; Department of Pediatric Cardiology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.; Department of Paediatrics, Pediatric Cardiology Unit, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Cardiol ; 369: 69-76, 2022 Dec 15.
Article en En | MEDLINE | ID: mdl-35926643
BACKGROUND: Anthracyclines and radiotherapy involving the heart region are cardiotoxic, but the potential cardiotoxicity of vincristine remains unknown. We assessed cardiac function in vincristine-treated >5-year childhood cancer survivors (CCS). METHODS AND RESULTS: We cross-sectionally compared echocardiograms of 101 vincristine-treated CCS (median age 35 years [range: 17-53], median vincristine dose 63 mg/m2) from the national Dutch Childhood Cancer Survivor Study, LATER cohort, to 101 age- and sex-matched controls. CCS treated with anthracyclines, radiotherapy involving the heart region, cyclophosphamide or ifosfamide were excluded. Twelve CCS (14%) versus four controls (4%; p 0.034) had a decreased left ventricular ejection fraction (LVEF; men <52%, women <54%). Mean LVEF was 58.4% versus 59.7% (p 0.050). Global longitudinal strain (GLS) was abnormal in nineteen (24%) CCS versus eight controls (9%; p 0.011). Mean GLS was 19.0% versus 20.1% (p 0.001). No ≥grade 2 diastolic dysfunction was detected. In multivariable logistic regression analysis CCS had higher risk of abnormal GLS (OR 3.55, p 0.012), but not abnormal LVEF (OR 3.07, p 0.065), than controls. Blood pressure and smoking history contributed to variation in LVEF, whereas obesity and diastolic blood pressure contributed to variation in GLS. Cumulative vincristine dose was not associated with either abnormal LVEF or abnormal GLS in multivariable models corrected for age and sex (OR per 50 mg/m2: 0.88, p 0.85 and 1.14, p 0.82, respectively). CONCLUSIONS: Vincristine-treated long-term CCS showed an abnormal GLS more frequently than controls. Their risk for future clinical cardiac events and the role of risk factor modification should be further elucidated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Supervivientes de Cáncer / Neoplasias Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male Idioma: En Revista: Int J Cardiol Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Supervivientes de Cáncer / Neoplasias Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male Idioma: En Revista: Int J Cardiol Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos