Left Atrial Mechanics and Integrated Calibrated Backscatter in Anthracycline-Treated Long-Term Survivors of Childhood Cancers

Li, Vivian Wing‐yi; Lai, Clare Tik-man; Liu, Anthony Pak-Yin; Cheuk, Dkl; Cheung, Yiu‐fai

doi:10.1016/j.ultrasmedbio.2017.05.017

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…The author explained that this might be due to fibrosis and cardiac remodeling. 15 Another study showed that among children exposed to anthracyclines, the short‐term effects on LA function were small for patients with preserved LVEF. 16 In our study, the LAV of breast cancer patients increased after chemotherapy, but there was no significant difference.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Chen

Liu

Sun

et al. 2022

Clinical Cardiology

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Background Left atrial (LA) function and mechanical dispersion changes in breast cancer patients treated with chemotherapy remain unclear. Hypothesis LA function and LA mechanical dispersion in breast cancer patients would be impaired after chemotherapy. Methods This single‐center retrospective study included 91 consecutive breast cancer patients treated with chemotherapy and 30 controls. Patients were examined by echocardiography three times at intervals. Conventional parameters, left ventricular strain, LA strain, and LA mechanical dispersion were evaluated and compared. Results LA strain during reservoir phase (LASr), conduit phase (LAScd), and contraction phase (LASct) all decreased markedly after chemotherapy and were lower than those of the controls (all p < .01). The standard deviation of time to peak positive strain during LA reservoir phase corrected by R‐R interval (LA SD‐TPSr) was significantly increased after chemotherapy and was higher than that of the controls ( p < .001). The change of LA function was expressed as Δ. Multivariate linear regression analyses showed that LAVIp (0.399, 95% confidence interval [CI]: 0.610, 1.756, p = .000) was independently associated with ΔLASr, LAPEF (−0.325, 95% CI: −45.123, −10.676, p = .002) and age (0.227, 95% CI: 0.021, 0.350, p = .027) were independently associated with ΔLAScd, and LAVImax (0.341, 95% CI: 0.192, 0.723, p = .001) was independently associated with ΔLASct. LAVImax (0.505, 95% CI: 0.000, 0.001, p = .039) and mitral E (−0.256, 95% CI: 0.000, 0.000, p = .024）were independently associated with ΔLA SD‐TPSr. Conclusions Mechanical function of LA declined after chemotherapy in breast cancer patients. With the decrease of LA mechanical function, LA mechanical dispersion assessed by two‐dimensional speckle‐tracking echocardiography increased significantly, and its clinical value needs to be further studied.

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Section: Discussionmentioning

confidence: 99%

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Chen

Liu

Sun

et al. 2022

Clinical Cardiology

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“…Shi et al did not find any difference in 3DE LAVIs measured immediately after completion of anthracycline therapy in non-Hodgkin lymphoma patients and the controls [6]. On the other hand, Li et al found significantly lower LAVIs in the long-term survivors of childhood cancers than in the control group [14]. Interestingly, Bergamini et al showed that there was no difference in maximal LAVI between patients with and without cardiotoxicity [9].…”

Section: Discussionmentioning

confidence: 99%

“…Li et al did not find any difference between the patients who had chemotherapy long time ago and the controls using only volumetric assessment of LA phasic function. Interestingly, strain analysis of LA phasic function showed that LA pump function was significantly reduced among cancer survivors [14]. Patel et al reported no statistically significant reduction in LA longitudinal strain among children and young adult survivors treated with anthracyclines [19].…”

Section: Discussionmentioning

confidence: 99%

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Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

Tadić

Genger

Cuspidi

et al. 2019

JCM

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: We aimed to explore left atrial (LA) remodeling in the patients with solid cancer before initiation of chemo- or radiotherapy. This retrospective investigation included 92 chemo- and radiotherapy-naive cancer patients and 40 age- and gender-matched controls with a similar cardiovascular risk profile as the cancer group. All participants underwent comprehensive echocardiographic examination before the start of chemo- or radiotherapy. LA phasic function was evaluated in volumetric and strain method. Indexed minimal and pre-A LA volumes were significantly higher in the cancer patients. Total and passive LA emptying fraction (EF) were significantly lower, whereas active LAEF was significantly higher in the cancer patients. LA total longitudinal strain was significantly lower in the cancer patients. Strain rate analysis of LA phasic function showed that LA function during systole and early diastole was reduced in the cancer group, while it was increased during late diastole. These findings indicated that LA reservoir and conduit functions, assessed with LA volumetric and strain analysis, were deteriorated in the cancer group. On the other hand, LA booster pump function was elevated in the cancer group in comparison with the controls. In the whole population, cancer was associated with reduced LA total longitudinal strain independently of age, gender, BMI, LV hypertrophy, E/e’ ratio, diabetes, and hypertension. LA phasic function was impaired in the chemo- and radiotherapy-naive cancer patients in comparison with the control group. Cancer, LV hypertrophy, and hypertension were associated with reduced LA longitudinal strain independently of other important clinical parameters.

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“…In adults, anthracycline exposure is associated with a significant change in LA GLS . In survivors of pediatric cancer exposed to anthracyclines, peak negative LA strain, LA reservoir, and LA booster pump function were reduced . However, in children and young adults, little is known about the acute effects of anthracycline exposure on LA function.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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Left Atrial Mechanics and Integrated Calibrated Backscatter in Anthracycline-Treated Long-Term Survivors of Childhood Cancers

Cited by 10 publications

References 39 publications

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

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

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