Evaluation Of Myocardial Functions In Children Receiving Anthracyclines

Objective: In our study, using echocardiographic measurements, patients with acute lymphoblastic leukemia receiving anthracycline therapy have been evaluated as for the presence of anthracycline-induced cardiac dysfunction, and it has been carried out to determine the statistically significant predictive echocardiographic parameters.Methods: Thirty cases (mean age 9.87 +/- 3.92 years, 13 males and 17 females) with acute lymphoblastic leukemia receiving anthracycline therapy were enrolled in the study, along with 30 age-matched controls. Their cardiac functions were evaluated echocardiographically with two dimensional, M-mode, PW Doppler and PW tissue Doppler methods.Results: Left ventricular cardiac functions were significantly reduced in the study group. The fractional shortening (FS) was 36.09 +/- 3.17 in the study group as opposed to 39.65 +/- 3.21 in controls (p=0.03). Diastolic functions (E/A ratio) weren't significantly altered in the study group. Right ventricular (RV) flow E/A was 1.36 +/- 0.29 and 1.34 +/- 0.69, respectively (p>0.05). Left ventricular (LV) flow E/A was 1.53 +/- 0.31 and 1.58 +/- 0.35, respectively (p>0.05). Myocardial performance index (MPI) was calculated in the study subjects using both PW Doppler and PW tissue Doppler methods, and compared to controls. RV flow MPI was 0.39 +/- 0.02, and 0.33 +/- 0.03, respectively (p<0.01). LV flow MPI was 0.41 +/- 0.08 and 0.34 +/- 0.04, respectively (p<0.01). RV tissue MPI was 0.44 +/- 0.04, and 0.39 +/- 0.05, respectively (p<0.01). LV tissue MPI was 0.42 +/- 0.02 and 0.36 +/- 0.01, respectively (p<0.01).Conclusion: The results of our study show that MPI and systolic functional changes are better indicators of anthracycline cardiotoxicity than diastolic functions. We suggest that RV and LV tissue MPI be primarily used in the search for anthracycline cardiotoxicity.