| ǥ :
|
ȣ - 530928 60 |
| Assessment of Cardiac Function by MUGA and Tissue Doppler Echocardiography in Children with Acute Lymphoblastic Leukemia receiving Anthracycline Chemotherapy in Asian Population |
| 고려대학교 구로병원 순환기내과¹, Department of cardiology², Department of Pediatrics, All india institute of medical sciences, New Delhi, India³ |
| Sureshkumar Ramasamy, 나승운¹, Anita Saxena², Rachana seth³, Sandeep Seth²,Ramakrishnan S ², |
Backgrounds: Anthracycline induced cardiotoxicity is a disorder that can limit the short and long-term survival in children with acute lymphoblastic leukemia (ALL). Our aim was to compare Tissue Doppler Image (TDI) echo and MUGA parameters (multi gated scan) for the assessment of left ventricular (LV) function in children with ALL before and 3 months after the completion of chemotherapy.Methods: MUGA and echocardiographic examination was performed in 15 patients (pts) at the baseline and 3 months after the starting the anthracycline chemotherapy. Offline analysis was done for Color Encoded TDI velocity analysis.Results: All pts had normal or near normal LV ejection fraction (EF) on MUGA and Simpson’s method at the baseline and after 3 months of chemotherapy and comparable with each other. Although E/A of the transmitral Doppler was normal, there was a statistically significant increase in the early peak diastolic tissue velocity (E’) in the basal lateral wall and the (E’) basal septum in the follow up TDI as compared with the baseline. (3.1 +/- 0.8cm/s Vs 4.6 +/- 0.8cm/s, p = 0.007; 4.6 +/- 1cm/s versus 05.7 +/- 1.1cm/s, p = 0.043). E/E’ Lateral wall decreased significantly during the follow up TDI (39+/- 14cm/s versus 20 +/- 5cm/s, p= 0.02).Conclusions: We found significant changes in the early peak myocardial tissue velocity (E’) at the basal septum and early peak diastolic tissue velocity of basal lateral wall (E’) and significant decrease in the E/E’ lateral wall in the follow up TDI, even though all the parameters measured by 2-D Echo, Doppler or MUGA are comparable with each other. The significance of these changes at this stage was not clear yet. These pts may need a close follow up to detect the abnormalities at the earliest.
|
|
Table; TDI results [All values Mean(+/- SD) or number]
|
TDI |
Prior to anthracycline chemotherapy |
Post anthracycline chemotherapy |
P value |
|
S' lateral , cm/s |
3 +/- 0.44 |
3 +/- 0.4 |
NS |
|
E' lateral ,cm/s |
3.14 +/- 0.85 |
4.6 +/- 0.8 |
0.007 |
|
A' lateral, cm/s |
2.34 +/-0.86 |
2.25 +/- 0.31 |
NS |
|
E'/A' lateral |
1.71 +/- 0.47 |
2.18 +/-0.46 |
NS |
|
E/E' lateral |
39 +/- 14 |
20 +/- 5 |
0.02 |
|
S' septal ,cm/s |
3.6 +/-0.6 |
3.6 +/- 0.44 |
NS |
|
E' septal ,cm/s |
4.6 +/- 1.1 |
5.7+-1.1 |
0.043 |
|
A' septal, cm/s |
3.3 +/- 1.3 |
2.6+/-0.7 |
NS |
|
E'/A' septal |
2.26 +/- 0.87 |
3.35 +/- 1.7 |
NS |
|
E/E' septal |
26+/- 1 |
19 +/- 9 |
0.06 |
|
|
|
