Diastolic Dysfunction is Common in Survivors of Pediatric Differentiated Thyroid Carcinoma

Hesselink, Mariëlle S Klein; Bocca, Gianni; Hummel, Yoran M.; Brouwers, Adrienne H.; Burgerhof, Johannes G. M.; Dam, Eveline W. C. M. van; Gietema, Jourik A.; Havekes, Bas; Heuvel‐Eibrink, Marry M. van den; Corssmit, Eleonora P M; Kremer, Leontien C. M.; Netea‐Maier, Romana T.; Pal, Helena J.H. van der; Peeters, Robin P.; Plukker, John; Ronckers, Cécile M.; Santen, Hanneke M van; Meer, Peter van der; Links, Thera P.; Tissing, Wim J. E.

doi:10.1089/thy.2017.0383

Cited by 18 publications

(28 citation statements)

References 32 publications

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“…Morbidity caused by treatment remains substantial, however, mainly as a consequence of surgical complications (permanent hypoparathyroidism and recurrent laryngeal nerve injury present in up to 32%) (18). Other late effects of childhood DTC treatment include dry mouth (19) or dry eyes that may have been caused by 131 I¯ treatment or side effects induced by TSH suppression therapy, such as altered diastolic function (20). Awareness of these late effects of given treatment in childhood is important.…”

Section: Discussionmentioning

confidence: 99%

New national recommendations for the treatment of pediatric differentiated thyroid carcinoma in the Netherlands

Lebbink

Dekker

Bocca

et al. 2020

European Journal of Endocrinology

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Background Currently, there are no European recommendations for the management of pediatric thyroid cancer. Other current international guidelines are not completely concordant. In addition, medical regulations differ between for instance the US and Europe. We aimed to develop new, easily accessible national recommendations for differentiated thyroid carcinoma (DTC) patients <18 years of age in the Netherlands as a first step towards a harmonized European Recommendation. Methods A multidisciplinary working group was formed including pediatric and adult endocrinologists, a pediatric radiologist, a pathologist, endocrine surgeons, pediatric surgeons, pediatric oncologists, nuclear medicine physicians, a clinical geneticist and a patient representative. A systematic literature search was conducted for all existing guidelines and review articles for pediatric DTC from 2000 until February 2019. The Appraisal of Guidelines, Research and Evaluation (AGREE) instrument was used for assessing quality of the articles. All were compared to determine dis- and concordances. The American Thyroid Association (ATA) pediatric guideline 2015 was used as framework to develop specific Dutch recommendations. Discussion points based upon expert opinion and current treatment management of DTC in children in the Netherlands were identified and elaborated. Results Based on the most recent evidence combined with expert opinion, a 2020 Dutch recommendation for pediatric DTC was written and published as an online interactive decision tree (www.oncoguide.nl). Conclusion Pediatric DTC requires a multidisciplinary approach. The 2020 Dutch Pediatric DTC Recommendation can be used as starting point for the development of a collaborative European recommendation for treatment of pediatric DTC.

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Section: Discussionmentioning

confidence: 99%

New national recommendations for the treatment of pediatric differentiated thyroid carcinoma in the Netherlands

Lebbink

Dekker

Bocca

et al. 2020

European Journal of Endocrinology

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“…Increased CVD morbidity and mortality have been reported among well-differentiated thyroid carcinoma patients, and THST was considered as a major cause of the cardiovascular problems [7,[10][11][12][13][14][15][16][17][18][19][20][21]. Klein Hesselink et al reported that a lower TSH level is associated with increased CVD mortality in thyroid cancer patients [10].…”

Section: Discussionmentioning

confidence: 99%

Radioactive Iodine Treatment and the Risk of Long-Term Cardiovascular Morbidity and Mortality in Thyroid Cancer Patients: A Nationwide Cohort Study

Kao

Chung

Chien

et al. 2021

JCM

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(1) Background: This study aimed to investigate the association between radioactive iodine (RAI) and long-term cardiovascular disease (CVD) morbidity/mortality in thyroid cancer. (2) Methods: The study was conducted using data from the Taiwan National Health Insurance Database during 2000–2015. Thyroid cancer patients aged ≥20 years were categorized into RAI (thyroidectomy with RAI) and non-RAI (thyroidectomy only) groups. The Cox proportional hazard regression model and Kaplan–Meier method were used for analysis. (3) Results: A total of 13,310 patients were included. Kaplan–Meier analysis demonstrated that the two groups had similar cumulative risks of CVD (log-rank p = 0.72) and CVD-specific mortality (log-rank p = 0.62). On Cox regression analysis of different RAI doses, the risk of CVD was higher in the cumulative dosage >3.7 GBq (hazard ratio = 1.69, 95% confidence interval = 1.24–2.40, p < 0.001). (4) Conclusions: RAI was not associated with an increased risk of CVD in thyroid cancer. However, CVD surveillance is indicated in the patients receiving the cumulative RAI dosage above 3.7 GBq.

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“…Hummel et al demonstrated subtle LV systolic and diastolic dysfunction, despite unchanged EF, at a median of 21.7 years follow-up in a small group of survivors of head and neck cancer treated with cranial and neck radiotherapy without additional systemic therapy, however the radiation dose was considerably higher in this group compared to CRT dose in ALL [35]. Furthermore, data from pediatric differentiated thyroid carcinoma survivors suggest that consequences of treatment with thyroidectomy and radioiodine may as well have delayed effects on the heart, including subclinical LV dysfunction [36].…”

Section: Discussionmentioning

confidence: 99%

Cranial Irradiation in Childhood Acute Lymphoblastic Leukemia Is Related to Subclinical Left Ventricular Dysfunction and Reduced Large Artery Compliance in Cancer Survivors

Sulicka-Grodzicka

Chyrchel

Totoń‐Żurańska

et al. 2019

JCM

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Long-term survivors of acute lymphoblastic leukemia (ALL), the most common childhood malignancy, are at remarkably increased risk of heart failure (HF) in middle age, most likely due anthracycline cardiotoxicity. The role of cranial radiation therapy (CRT) in the development of left ventricular (LV) dysfunction, a predecessor of overt HF, remains unclear. Our aim was to compare LV function and systemic arterial properties according to past CRT in young adult survivors of anthracycline-treated ALL. We studied young adult survivors of childhood ALL at a median of 16 years from diagnosis treated with anthracycline-based chemotherapy, with (n = 12) or without (n = 30) CRT. In addition to fractional shortening (FS) and ejection fraction (EF), LV function was quantified by tissue Doppler imaging of the mitral annulus. Aortic strain/distensibility and arterial compliance were derived from echocardiography and simultaneously recorded pulse pressure. Despite similar FS and EF, peak mitral annular systolic velocity (median (interquartile range): 9.0 (7.5–10.0) vs. 10.0 (8.8–11.5) cm/s, p = 0.05), and early diastolic velocity (13.8 (13.0–14.8) vs. 15.5 (14.0–17.3), p = 0.01) were decreased after chemotherapy combined with CRT compared to chemotherapy without CRT. Systemic arterial compliance was lower in post-CRT subjects (1.0 (0.8–1.2 vs. 1.4 (1.1–1.7) mL/mmHg, p = 0.002). Aortic strain and distensibility were similar regardless of prior CRT. In conclusion, lower arterial compliance and subclinical LV dysfunction may be possible late consequences of past CRT in adult survivors of childhood ALL. Whether arterial stiffening is associated with future HF development in CRT-exposed ALL survivors remains to be investigated.

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Diastolic Dysfunction is Common in Survivors of Pediatric Differentiated Thyroid Carcinoma

Abstract: While systolic function is unaffected, diastolic dysfunction is frequently observed in asymptomatic long-term survivors of pediatric DTC, which may suggest early cardiac aging.

Cited by 18 publications

References 32 publications

New national recommendations for the treatment of pediatric differentiated thyroid carcinoma in the Netherlands

New national recommendations for the treatment of pediatric differentiated thyroid carcinoma in the Netherlands

Radioactive Iodine Treatment and the Risk of Long-Term Cardiovascular Morbidity and Mortality in Thyroid Cancer Patients: A Nationwide Cohort Study

Cranial Irradiation in Childhood Acute Lymphoblastic Leukemia Is Related to Subclinical Left Ventricular Dysfunction and Reduced Large Artery Compliance in Cancer Survivors

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