Publication:

Assessment of left ventricular function in pediatric oncology by two different methods of echocardiography: a short-term outcome

Background Chemotherapy-induced myocardial dysfunction (CIMD) is a documented actuate of heightened morbidity and mortality. The gold standard for the surveillance of CIMD is the serial echocardiogram. Two-dimensional speckle echocardiography i.e. global longitudinal strain (GLS) is affirmative diagnostic tool than conventional echocardiography.

Methods We retrospectively reviewed the data of children (age between 6 months to 18 years) who received cardio-toxic chemotherapeutic agents and underwent echocardiography assessment with conventional and GLS imaging at-least 2 times between January 2020 to January 2021 in The Indus Hospital, Karachi at start, 3rd months and 6th months of treatment.

Results We enrolled 122 patients in our study. The mean age was 8.19±4.43. 82 (67.2%) children got the 2 echocardiographic evaluations while 40 (32.8%) children completed three. Of 82 subjects, 17 (22.6%) had a significant reduction in early myocardial deformation indices as measured by two-dimensional (2D) STE using GLS at the end of 3 months of chemotherapy. Before the start of therapy, mean values of ejection fraction (EF), fractional shortening (FS) and GLS were 68.6±10.44, 38.8±7.44, and -20.7±4.19 respectively. At 3rd month and 6th month follow up, EF decreased 65.80±9.00 and 62.06±10.62 (p value 0.000) respectively while the values for GLS decreased significantly as -18.4±3.86, -16.68±3.63 (p value 0.02) respectively.

Conclusions GLS is an effective, and non-invasive cardiac imaging modality than a conventional echocardiography in assessment of left ventricular (LV) dysfunction in non-symptomatic as well as in symptomatic children with cancers.