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Pediatric malignancies: Is the prechemotherapy left ventricular function normal?
dc.contributor.authorAkam‐venkata, Jyothsna
dc.contributor.authorKadiu, Gilda
dc.contributor.authorGalas, James
dc.contributor.authorAggarwal, Sanjeev
dc.date.accessioned2019-10-30T15:29:57Z
dc.date.availableWITHHELD_12_MONTHS
dc.date.available2019-10-30T15:29:57Z
dc.date.issued2019-09
dc.identifier.citationAkam‐venkata, Jyothsna ; Kadiu, Gilda; Galas, James; Aggarwal, Sanjeev (2019). "Pediatric malignancies: Is the prechemotherapy left ventricular function normal?." Echocardiography 36(9): 1727-1735.
dc.identifier.issn0742-2822
dc.identifier.issn1540-8175
dc.identifier.urihttps://hdl.handle.net/2027.42/151839
dc.description.abstractPurposeWe compared the left ventricular (LV) systolic function in children with cancer before initiation of chemotherapy with matched controls using speckle tracking echocardiography.Methods and resultsIn this retrospective study, we analyzed the echocardiograms of 89 cancer patients before the initiation of chemotherapy and 82 ageâ (8.4 ± 5.2 vs. 8.9 ± 3.9 years, P = .4) and genderâ matched (64% vs. 67%, males, P = .4) healthy controls. Peak systolic LV longitudinal strain (LS) was significantly lower in cancer patients in apical two (â 19.8 ± 3.0 vs. â 23.5 ± 4.0, P < .001), three (â 19.4 ± 3.2 vs. â 23.4 ± 4.0, P < .001), and fourâ chamber views (â 19.7 ± 3.4 vs. â 22.5 ± 3.0, P < .001) compared to controls, as was global longitudinal strain (GLS) (â 19.8 ± 2.7 vs. â 23.4 ± 3.2, P < .001). The prechemotherapy group also had a higher E/e’ ratio compared to controls at the septal (9.3 ± 3.9 vs. 7.9 ± 1.7, P = .005) and lateral annulus (7.9 ± 3.3 vs. 5.9 ± 1.4, P < .001) of the mitral valve. The LV ejection fraction was lower in cancer patients compared to controls (63.5 ± 4.9 vs. 66.8 ± 4.1, P < .001), although still within normal limits. There were no differences in LV myocardial performance index (0.30 ± 0.05 vs. 0.30 ± 0.09, P < .65) and shortening fraction (35.8 ± 5.2 vs. 36.1 ± 6.1, P < 0.75) between the two groups. Subgroup analysis showed no difference in LV GLS between patients with solid tumors (n = 56) and blood cancers (n = 33) (GLS â 19.2 ± 2.9 vs. 19.5 ± 2.4, P > 0.05).ConclusionOur data demonstrating abnormalities in LV GLS in pediatric cancer patients even prior to initiation of chemotherapy are novel and perplexing. Further longitudinal followâ up is required to assess the implications of this abnormal LV function in these patients.
dc.publisherWiley Periodicals, Inc.
dc.subject.otherpediatric echocardiography
dc.subject.othermalignancy
dc.subject.otherstrain
dc.titlePediatric malignancies: Is the prechemotherapy left ventricular function normal?
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelInternal Medicine and Specialties
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/151839/1/echo14461_am.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/151839/2/echo14461.pdf
dc.identifier.doi10.1111/echo.14461
dc.identifier.sourceEchocardiography
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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