Objective: Assessment of systolic and diastolic functions and tissue Doppler indices by stress echocardiography for the early determination of late anthracycline-induced cardiotoxicity in asymptomatic children.
Method: Dobutamine stress echocardiography was performed on 20 anthracycline-treated asymptomatic patients ( 14 M, 6F; mean age 18.4±3.2 years) and age-matched healthy control group ( 14 F, 4 E; mean age:19.2±4.0 years).
Echocardiographic examination was performed : at rest, 5,10, 15 and 20µg/kg/min dobutamine infusions with 5 minutes interval. Tissue Doppler measurements were recorded at annular and mid segment of right ventricle, interventricular septum and left ventricle.
Results: At rest patients’ isovolemic contraction and isovolemic relaxation times were longer than controls; by dobutamine infusions patients’ percentage of left ventricular posterior wall thickeness values were decreased and left ventricular systolic wall stress , LVDd, LVSd, mitral accelaration and deceleration time were increased, Although ejection fractions and fractional shortening measurements were in normal limits during dobutamine infusions; right ventricule, interventricular septum and left ventricular tissue MPI and LV flow MPI values were higher than controls during test. Patients LV tissue MPI was increased much more than LV flow MPI by stress echocardiography Cumulative anthracycline doses had positive correlation between LV tissue MPI and showed negative correlation with percentage of LV posterior wall thickening by stress echocardiography
Conclusion: Tissue myocardial performance indexes are more sensitive measurements for the determination of left ventricular disfunction and stress echocardiography is sensitive technique for find out of the late cardiac toxicity in anthracycline-treated asymptomatic patients