Assessment of late anthracycline-induced cardiotoxicity by 123I-mIBG cardiac scintigraphy in patients treated during childhood and adolescence

Abstract

Although the pathophysiology behind ATC cardiotoxicity is most likely multifactorial, myocardial sympathetic activity is not associated with a reduction in LVEF 5-years after completion of chemotherapy.

Left atrial function in children and young adult cancer survivors treated with anthracyclines

“…However, in children and young adults, little is known about the acute effects of anthracycline exposure on LA function. Much of the published pediatric literature focuses on the change in LV function following anthracycline exposure, for which there is a strong relationship . Following cancer treatment, childhood cancer survivors have shown a timeline of subclinical LV disease that differs from adults .…”

Anthracycline-induced cardiomyopathy: The search continues

“…Recent reviews have summarized the mechanism by which I-123 MIBG is taken up by the nerve terminal, the utility of this agent, and the technical aspects of its imaging. [24][25][26][27] One of the strengths of the current study by dos Santos 28 is that all of the subjects were relatively young (mean age of 16), when identification of early anthracycline-induced cardiomyopathy would be most critical. The subjects were a median of 5.3 years out from their chemotherapy.…”

123I‐MIBG imaging for detection of anthracycline‐induced cardiomyopathy

“…It was concluded that future studies should incorporate a multimodality imaging approach with biomarker studies to improve early identification of patients at high risk of cardiotoxic side effects. However, a recent retrospective study was not able to use 123 I-MIBG variables, including late HMR and WOR, to discriminate 89 asymptomatic anthracycline-treated childhood cancer survivors from 40 healthy controls (Dos Santos et al, 2015). However, case reports and small studies of patients with significant clinical recovery from heart failure symptoms have suggested that anthracycline-related HF should not necessarily be considered an irreversible condition (Saini et al, 1987;Jensen et al, 1996), but the mechanisms underlying a potential clinical recovery are sparsely investigated.…”