Assessment of Left Ventricular Dysfunction in Children Undergoing Chemotherapy

Background

In Taiwan, children with malignancies are treated under the protocols of the Taiwan Pediatric Oncology Group (TPOG). The purpose of this study was to determine the change in left ventricular (LV) function in pediatric patients undergoing chemotherapy.

Methods

A total of 19 pediatric patients (mean age, 12.5 ± 4.6 years; 11 males, 8 females) were enrolled. We divided the patients into 2 groups: (1) osteogenic sarcoma (OGS) group (n = 12; Group I); and (2) non-osteogenic sarcoma (non-OGS) group (n = 7; Group II). The accumulated dosages of anthracycline in Group I and II patients were 144.3 ± 56.4 mg/M² and 131.7 ± 105.5 mg/M² (p= 0.735), respectively. The children received echocardiography to investigate the parameters of LV systolic function, LV diastolic function, and myocardial performance index (MPI) after the entire chemotherapy course.

Results

Higher E/A ratio (1.71 ± 0.37), shorter isovolumic relaxation time (IRT, 42 ± 19.14 ms), and shorter deceleration time (DT, 140.3 ± 40.6 ms) were demonstrated in these patients. There was no statistically significant difference in the E/A ratio and DT between the 2 groups. Group I children were older (14.4 ± 3.7 vs. 9.3 ± 4.5 years; p = 0.015) and had lower MPI (0.20 ± 0.02 vs. 0.28 ± 0.07; p = 0.031) than Group II children.

Conclusion

The children treated with chemotherapy using the TPOG protocol had a shorter IRT, higher E/A ratio and shorter DT. No significant evidence of anthracycline-related cardiotoxicity was found in any of the children in this study undergoing chemotherapy with the TPOG protocol.

Key Words:  anthracycline , chemotherapy , children , left ventricular dysfunction

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