Higher doses of anthracyclines, younger age tied to increased risk of worsened left ventricular function

-- Lindsey Marcellin

Monday, July 26, 2010 (Last Updated: 07/27/2010)

MONDAY, July 26 (HealthDay News) -- Decreased cardiac function occurs in 27 percent of five-year childhood cancer survivors (CCSs), and higher cumulative anthracycline dose, radiation to the thorax, and younger age at diagnosis are all associated with left ventricular shortening fraction (LVSF) in these patients, according to a study in the July 26 issue of the Archives of Internal Medicine.

Helena J. van der Pal, M.D., of the Academic Medical Center in Amsterdam, Netherlands, and colleagues studied 514 adult five-year CCSs who had been treated with a variety of potentially cardiotoxic treatments. The prevalence of cardiac dysfunction in this population was assessed.

The researchers found that the median echocardiographic LVSF was 33.1 percent. Twenty-seven percent of the CCSs had subclinical cardiac dysfunction, defined as LVSF of less than 30 percent. Factors associated with having a decreased LVSF included younger age at diagnosis, higher cumulative dose of anthracycline, and radiation to the chest. High-dose cyclophosphamide and ifosfamide were not associated with decreased LVSF.

"In conclusion, more than 25 percent of young adult CCSs had subclinical cardiac dysfunction at their first visit to the outpatient clinic for late effects of childhood cancer. Continued monitoring of all CCSs treated with potentially cardiotoxic therapy with or without subclinical cardiac dysfunction is necessary to identify CCSs who could possibly benefit from early treatment, which could avoid further deterioration of cardiac function. The most important risk factors for developing subclinical cardiac dysfunction are the cumulative anthracycline dose, radiotherapy to the thorax and younger age at diagnosis," the authors write.

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Specialties Hematology & Oncology

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