Thorac Cardiovasc Surg 2017; 65(S 02): S111-S142
DOI: 10.1055/s-0037-1599018
DGPK Poster Presentations
Sunday, February 12, 2017
DGPK: e-Poster: Imaging
Georg Thieme Verlag KG Stuttgart · New York

Early Identification of Subtle Left Ventricular and Atrial Dysfunction among Asymptomatic Survivors of Childhood Myeloid Leukemia: Insights from the Novel Three-Dimensional Speckle Tracking Echocardiography

M. M. Abd
1   Department of Pediatric Cardiology, Saarland University Hospital, Homburg Saarland, Germany
,
Z. Salah
2   Department of Pediatric Cardiology, Cairo University, Cairo, Egypt
,
S. Abbas
3   Department of Pediatric Oncology, Egypt Cancer Network 57357, Cairo, Egypt
,
R. ELKaffas
2   Department of Pediatric Cardiology, Cairo University, Cairo, Egypt
,
H. Hamza
2   Department of Pediatric Cardiology, Cairo University, Cairo, Egypt
,
H. H. Abdul
1   Department of Pediatric Cardiology, Saarland University Hospital, Homburg Saarland, Germany
,
A.E.M. Helal
2   Department of Pediatric Cardiology, Cairo University, Cairo, Egypt
› Author Affiliations
Further Information

Publication History

Publication Date:
02 February 2017 (online)

   All articles of this category

Aim: To assess the value of novel three dimensional (3D) echocardiography and 3D speckle tracking echocardiography (3D-STE) for early detection of subtle LV myocardial dysfunction on ventricular and atrial levels in asymptomatic survivors of childhood acute myeloid leukemia after anthracycline therapy.

Methods: Thirty-five survivors of childhood acute myeloid leukemia (mean age 13.5 ± 4.4 years) treated with Anthracycline and 23 age-matched controls were studied. The mean period of follow up after Anthracyclines therapy was 2.3 ± 1.5 years. All patients and control underwent 3D echocardiography and 3D-STE to assess global longitudinal (GLS), circumferential (GCS) and area strain (GAS). The left atrial volumes were measured by 3D echocardiography at end-systole (LAESV), onset of atrial kick (LAKV) and at end-diastole (LAEDV). The atrial reservoir function (LARF) and pump function (LAPF) were assessed.

Result: Compared to controls, patients had reduced GLS (16 ± 3.11 vs. 18.30 ± 2.38%, p = 0.006), and area strain (24.29 ± 4.12 vs. 26.78 ± 2.64%, p = 0.015). No significant statistical difference was found between patients and control regarding GCS. Compared to control, patients had a reduced LAESV (19.4 ± 4.74 vs. 24.03 ± 7.07 mL/m2, p = 0.004, LARF (40.61 ± 11.29 vs. 50.64 ± 7.43%, p = 0.005), LAPF (19.10 ± 7.34 vs. 25.33 ± 8.26%, p = 0.005). Among patients, the GLS correlated with LARF (r = 0.49, p = 0.003) and LAPF (r = 0.58, p = 0.001).

Conclusion: 3D-STE enables assessment of the deleterious effect of Anthracyclines on the longitudinal myocardial deformation thus providing a novel tool for early detection of subtle LV dysfunction in childhood myeloid leukemia survivors. Atrial functions and volumes among this cohort are reduced and are partially related to ventricular longitudinal deformation dysfunction.