Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Radiology and Nuclear Medicine, Medical UltraSound Imaging Centre (MUSIC), Radboud University Medical Center, Nijmegen, The Netherlands.
Int J Cardiovasc Imaging. 2021 Dec;37(12):3469-3475. doi: 10.1007/s10554-021-02347-4. Epub 2021 Aug 6.
The purpose of this study was to investigate left ventricular contraction patterns in asymptomatic Childhood cancer survivors (CCS) using two-dimensional speckle tracking echocardiography (2DSTE). Left ventricular longitudinal and circumferential myocardial parameters were assessed using 2DSTE, in asymptomatic CCS and age matched healthy controls. Time to peak (T2P) systolic strain was quantified. Dyssynchrony index (DI) was measured by calculating the standard deviation of T2P systolic strain of six segments in each view. Difference between T2P systolic longitudinal strain of septal and lateral wall was also assessed as a parameter for dyssynchrony. We included 115 CCS with a median age of 17.2 years (range 5.6-39.5) and a median follow up of 11.3 years (range 4.9-29.5) and 119 controls. Conventional echocardiographic parameters and global longitudinal strain were significantly decreased in CCS compared to controls (p < 0.01 and p = 0.02, respectively). Dyssynchrony index did not differ between CCS and controls. There was a clinically insignificant smaller absolute difference between T2P systolic longitudinal of septal and lateral wall in CCS compared to controls. We showed no difference in longitudinal or circumferential left ventricular dyssynchrony in CCS compared to controls using 2DSTE. Future research should focus on assessing dyssynchrony in more segments and a larger CCS population, using both 2D and 3DSTE.
本研究旨在通过二维斑点追踪超声心动图（2DSTE）研究无症状儿童癌症幸存者（CCS）的左心室收缩模式。使用 2DSTE 评估无症状 CCS 和年龄匹配的健康对照组的左心室长轴和环向心肌参数。测量收缩期峰值时间（T2P）应变。通过计算每个视图 6 个节段 T2P 收缩期应变的标准差来测量同步指数（DI）。还评估了间隔和侧壁 T2P 收缩期纵向应变之间的差异，作为同步性的参数。我们纳入了 115 名中位年龄为 17.2 岁（范围 5.6-39.5）、中位随访时间为 11.3 年（范围 4.9-29.5）的 CCS 和 119 名对照者。与对照组相比，CCS 的常规超声心动图参数和整体纵向应变明显降低（p<0.01 和 p=0.02）。CCS 和对照组之间的同步指数没有差异。与对照组相比，CCS 中 T2P 收缩期纵向间隔和侧壁之间的绝对差异较小，但无临床意义。与对照组相比，CCS 中左心室长轴和环向收缩不同步无差异。未来的研究应重点使用 2D 和 3DSTE 评估更多节段和更大的 CCS 人群的不同步性。
