Cardiac Functional Evaluation Using Vector Velocity Imaging After Chemotherapy Including Anthracyclines in Children With Cancer

BACKGROUND AND OBJECTIVES Anthracyclines are effective drugs that are widely used in pediatric cancer treatment. Previous studies have demonstrated that exposure to low-dose anthracyclines (<300 mg/m(2)) induces a progressive decrease in cardiac function during long-term follow-up. The goal of this study was to assess left ventricular function using vector velocity imaging (VVI) in children undergoing low-dose anthracycline therapy. SUBJECTS AND METHODS We examined 14 asymptomatic patients who had been treated with anthracyclines and had normal fractional shortening (FS) and ejection fraction (EF). In all of the patients, standard two-dimensional (2D) pulsed and tissue Doppler echocardiographic measurements were taken from an apical 4-chamber view. The peak myocardial velocity, peak strain rate (SR), peak strain, and displacement were obtained from VVI. Data were compared with 14 age-matched healthy controls. RESULTS From the regional wall motion analysis using VVI in the left ventricle, the peak myocardial velocity and displacement of the lateral wall were increased significantly more than the septum, and there were no significant differences between the patients and the controls. Although systolic strain, and the systolic and diastolic SRs showed no significant differences between the septum and lateral wall in the controls, those of septum, in the patients, were decreased significantly more than those of lateral wall (p<0.05). In comparison with the controls, these changes in septal strain and SRs of patients were significant (p<0.05). CONCLUSION Anthracycline therapy, even low-dose, can induce changes in regional wall function before global dysfunction. Also, the strain and SR obtained from VVI may be useful for early detection of these changes.