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Sade LE, Faletra FF, Pontone G, Gerber BLM, Muraru D, Edvardsen T, Cosyns B, Popescu BA, Klein A, Marwick TH, Cameli M, Saric M, Thomas L, Ajmone Marsan N, Fontes-Carvalho R, Podlesnikar T, Fontana M, La Gerche A, Petersen SE, Moharem-Elgamal S, Bittencourt MS, Vannan MA, Glikson M, Peichl P, Cochet H, Stankovic I, Donal E, Thomas D, Marta DRS. The role of multi-modality imaging for the assessment of left atrium and left atrial appendage: a clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC). Eur Heart J Cardiovasc Imaging 2025; 26:385-413. [PMID: 39812172 DOI: 10.1093/ehjci/jeaf014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025] Open
Abstract
Structural, architectural, contractile, or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodelling has become a cornerstone diagnostic and prognostic marker. The structure and the function of the LA and left atrial appendage (LAA), which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation, cardioembolism, heart failure, and mitral valve diseases. Rational use of various imaging modalities is key to obtain the relevant clinical information. Accordingly, this clinical consensus document from the European Association of Cardiovascular Imaging, in collaboration with the European Heart Rhythm Association, provides comprehensive, up-to-date, and evidence-based guidance to cardiologists and cardiac imagers for the best practice of imaging LA and LAA for the diagnosis, management, and prognostication of the patients.
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Affiliation(s)
- Leyla Elif Sade
- Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
- Department of Cardiology, University of Pittsburgh Medical Center, Heart and Vascular Institute, Pittsburgh, PA, USA
| | | | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Bernhard Lothar Marie Gerber
- Department of Cardiovascular Diseases and CARD Unit, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Denisa Muraru
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Cardiology, Instituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bernard Cosyns
- Department of Cardiology, Centrum voor Hart- en Vaatziekten (CHVZ), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Bogdan A Popescu
- Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu', University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Bucharest, Romania
| | - Allan Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas H Marwick
- Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Muhamed Saric
- Leon H. Charney Division of Cardiology, New York University, Langone Health, New York, NY, USA
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, Sydney, Australia
- Westmead Clinical School, University of Sydney, Australia
- Southwest Clinical School, University of New South Wales, Sydney, Australia
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Ricardo Fontes-Carvalho
- Departamento de Cardiologia-Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
- RISE-Health, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Tomaz Podlesnikar
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marianna Fontana
- Center for Amyloidosis, Division of Medicine, National Amyloidosis Centre, Royal Free Hospital UK, University College London, UK
| | - Andre La Gerche
- HEART Lab, St Vincent's Institute, Fitzroy, VIC, Sidney, Australia
| | - Steffen Erhard Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Sarah Moharem-Elgamal
- Adult Congenital Heart Disease Centre, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK
| | - Marcio Sommer Bittencourt
- Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
- Department of Cardiology, University of Pittsburgh Medical Center, Heart and Vascular Institute, Pittsburgh, PA, USA
| | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, USA
| | - Michael Glikson
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center Eisenberg R&D authority, Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Petr Peichl
- Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Hubert Cochet
- Department of Cardiovascular Imaging, University of Bordeaux, CHU Bordeaux, IHU LIRYC-INSERM 1045, Bordeaux, France
| | - Ivan Stankovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Erwan Donal
- Department of Cardiology, University of Rennes, CHU Rennes, Inserm, LTSI -UMR 1099, Rennes, France
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Linders AN, Dias IB, López Fernández T, Tocchetti CG, Bomer N, Van der Meer P. A review of the pathophysiological mechanisms of doxorubicin-induced cardiotoxicity and aging. NPJ AGING 2024; 10:9. [PMID: 38263284 PMCID: PMC10806194 DOI: 10.1038/s41514-024-00135-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
The population of cancer survivors is rapidly increasing due to improving healthcare. However, cancer therapies often have long-term side effects. One example is cancer therapy-related cardiac dysfunction (CTRCD) caused by doxorubicin: up to 9% of the cancer patients treated with this drug develop heart failure at a later stage. In recent years, doxorubicin-induced cardiotoxicity has been associated with an accelerated aging phenotype and cellular senescence in the heart. In this review we explain the evidence of an accelerated aging phenotype in the doxorubicin-treated heart by comparing it to healthy aged hearts, and shed light on treatment strategies that are proposed in pre-clinical settings. We will discuss the accelerated aging phenotype and the impact it could have in the clinic and future research.
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Affiliation(s)
- Annet Nicole Linders
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, The Netherlands
| | - Itamar Braga Dias
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, The Netherlands
| | - Teresa López Fernández
- Division of Cardiology, Cardiac Imaging and Cardio-Oncology Unit, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain
| | - Carlo Gabriele Tocchetti
- Department of Translational Medical Sciences (DISMET), Federico II University, Naples, Italy
- Centre for Basic and Clinical Immunology Research (CISI), Federico II University, Naples, Italy
- Interdepartmental Centre of Clinical and Translational Sciences (CIRCET), Federico II University, Naples, Italy
- Interdepartmental Hypertension Research Centre (CIRIAPA), Federico II University, Naples, Italy
| | - Nils Bomer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, The Netherlands
| | - Peter Van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, Groningen, The Netherlands.
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Balaji S, Antony AK, Tonchev H, Scichilone G, Morsy M, Deen H, Mirza I, Ali MM, Mahmoud AM. Racial Disparity in Anthracycline-induced Cardiotoxicity in Breast Cancer Patients. Biomedicines 2023; 11:2286. [PMID: 37626782 PMCID: PMC10452913 DOI: 10.3390/biomedicines11082286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer has become the most common cancer in the US and worldwide. While advances in early detection and treatment have resulted in a 40% reduction in breast cancer mortality, this reduction has not been achieved uniformly among racial groups. A large percentage of non-metastatic breast cancer mortality is related to the cardiovascular effects of breast cancer therapies. These effects appear to be more prevalent among patients from historically marginalized racial/ethnic backgrounds, such as African American and Hispanic individuals. Anthracyclines, particularly doxorubicin and daunorubicin, are the first-line treatments for breast cancer patients. However, their use is limited by their dose-dependent and cumulative cardiotoxicity, manifested by cardiomyopathy, ischemic heart disease, arrhythmias, hypertension, thromboembolic disorders, and heart failure. Cardiotoxicity risk factors, such as genetic predisposition and preexisting obesity, diabetes, hypertension, and heart diseases, are more prevalent in racial/ethnic minorities and undoubtedly contribute to the risk. Yet, beyond these risk factors, racial/ethnic minorities also face unique challenges that contribute to disparities in the emerging field of cardio-oncology, including socioeconomic factors, food insecurity, and the inability to access healthcare providers, among others. The current review will address genetic, clinical, and social determinants that potentially contribute to this disparity.
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Affiliation(s)
- Swetha Balaji
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Antu K. Antony
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Harry Tonchev
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Giorgia Scichilone
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Mohammed Morsy
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Hania Deen
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Imaduddin Mirza
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Mohamed M. Ali
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
| | - Abeer M. Mahmoud
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.B.); (A.K.A.); (H.T.); (G.S.); (M.M.); (H.D.); (I.M.); (M.M.A.)
- Department of Kinesiology, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Yıldırım A, Tokgözoğlu SL, Yıldırım M, Şener YZ, Okşul M, Akçay D, Kocaefe Ç, Dönmez G, Yorgun H, Özer N. Role of echocardiography on early diagnosis of atrial remodelling and fibrosis in elite athletes. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1299-1306. [PMID: 37040062 DOI: 10.1007/s10554-023-02845-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 03/22/2023] [Indexed: 04/12/2023]
Abstract
There is emerging data indicating that long-standing vigorous exercise may be associated with atrial structural remodelling. This remodelling process is may be the cause of the increasing frequency of atrial arrythmias in athletes. Early diagnosis of atrial remodelling by atrial imaging could have a role in management of atrial arrythmias in elite athletes. In this study we aimed to diagnose early phases of atrial remodelling in elite athletes. Two groups of athletes including professional weight lifters (n = 33), professional marathoners (n = 32) and sedentary participants (n = 30) were enrolled. We also studied patients who received cardiotoxic chemotherapy (n = 10) for comparison. Serum TGF-beta level as a marker of fibrosis was measured. Both left atrial (LA) 3D volume and strain values were analysed. There was a positive correlation between serum TGF-beta levels and LA volumes and negative correlation between TGF-beta levels and strain values. TGF-beta levels were higher among chemotherapy and weight lifter groups, compared to control and marathoner groups [mean 0.57 ± 0.3 and 0.55 ± 0.2 vs. 0.45 ± 0.2 and 0.47 ± 0.2, respectively, p = 0.005]. LA volumes were higher among chemotherapy and weight lifter groups [median 33 (26-38) and 31 (23-36) respectively, p = 0.005], and strain values were lower in these two groups [mean 20.3 ± 2.5 and 24.6 ± 4.5, respectively, p < 0.005] compared to control and marathoner groups. Total exercise volume was higher in weight lifter group compared to marathoners [13,780 (2496-36,400) vs. 4732 (780-44928), respectively, p = 0.001]. There wasn't any difference between any group regarding left ventricular systolic and diastolic functions. Vigorous exercise causes atrial remodelling and fibrosis in elite athletes. Strength exercise carries higher risk for atrial fibrosis than endurance exercise. Burden of exercise is correlated with the severity of cardiac fibrosis. Echocardiographic evaluation of the left atrium and TGF-beta levels may help to detect subclinical cardiac remodelling and fibrosis.
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Affiliation(s)
- Arzu Yıldırım
- Cardiology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Cardiology Department, Medipol University Hospital, İstanbul, Turkey
| | | | - Murat Yıldırım
- Sports Medicine Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yusuf Ziya Şener
- Cardiology Department, Beypazarı State Hospital, Ankara, Turkey.
- Cardiology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Metin Okşul
- Cardiology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Cardiology Department, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Duygu Akçay
- Medical Biology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Çetin Kocaefe
- Medical Biology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gürhan Dönmez
- Sports Medicine Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hikmet Yorgun
- Cardiology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Necla Özer
- Cardiology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Chen N, Liu A, Sun S, Wei H, Sun Q, Shang Z, Sun Y, Fu T, Wang H, Xia Y, Hua L, His DH, Cong T. Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy. Clin Cardiol 2022; 45:540-548. [PMID: 35294063 PMCID: PMC9045082 DOI: 10.1002/clc.23813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/27/2022] [Accepted: 03/03/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Left atrial (LA) function and mechanical dispersion changes in breast cancer patients treated with chemotherapy remain unclear. HYPOTHESIS LA function and LA mechanical dispersion in breast cancer patients would be impaired after chemotherapy. METHODS This single-center retrospective study included 91 consecutive breast cancer patients treated with chemotherapy and 30 controls. Patients were examined by echocardiography three times at intervals. Conventional parameters, left ventricular strain, LA strain, and LA mechanical dispersion were evaluated and compared. RESULTS LA strain during reservoir phase (LASr), conduit phase (LAScd), and contraction phase (LASct) all decreased markedly after chemotherapy and were lower than those of the controls (all p < .01). The standard deviation of time to peak positive strain during LA reservoir phase corrected by R-R interval (LA SD-TPSr) was significantly increased after chemotherapy and was higher than that of the controls (p < .001). The change of LA function was expressed as Δ. Multivariate linear regression analyses showed that LAVIp (0.399, 95% confidence interval [CI]: 0.610, 1.756, p = .000) was independently associated with ΔLASr, LAPEF (-0.325, 95% CI: -45.123, -10.676, p = .002) and age (0.227, 95% CI: 0.021, 0.350, p = .027) were independently associated with ΔLAScd, and LAVImax (0.341, 95% CI: 0.192, 0.723, p = .001) was independently associated with ΔLASct. LAVImax (0.505, 95% CI: 0.000, 0.001, p = .039) and mitral E (-0.256, 95% CI: 0.000, 0.000, p = .024)were independently associated with ΔLA SD-TPSr. CONCLUSIONS Mechanical function of LA declined after chemotherapy in breast cancer patients. With the decrease of LA mechanical function, LA mechanical dispersion assessed by two-dimensional speckle-tracking echocardiography increased significantly, and its clinical value needs to be further studied.
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Affiliation(s)
- Na Chen
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ansheng Liu
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Siyao Sun
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Hong Wei
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Qiaobing Sun
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhijuan Shang
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Yinghui Sun
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Tingting Fu
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Hongjiang Wang
- Department of Breast Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Yunlong Xia
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Lanqi Hua
- Department of Cardiovascular Ultrasound, Massachusetts General Hospital Cardiac Ultrasound Lab, Boston, Massachusetts, USA
| | - David H His
- Department of Cardiology, Stamford Hospital, Stamford, Connecticut, USA
| | - Tao Cong
- Department of Cardiovascular Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
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Menon D, Kadiu G, Sanil Y, Aggarwal S. Anthracycline Treatment and Left Atrial Function in Children: A Real-Time 3-Dimensional Echocardiographic Study. Pediatr Cardiol 2022; 43:645-654. [PMID: 34787697 DOI: 10.1007/s00246-021-02769-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022]
Abstract
Anthracycline (AC) therapy is associated with left ventricular (LV) dysfunction. Left atrial (LA) size and function are used to assess LV diastolic function in heart failure in adults. Data on LA size and function following AC therapy in children is limited. We hypothesized that LA size and function will be abnormal in children following AC chemotherapy. This retrospective review included patients who received AC for pediatric cancers. Controls had normal echocardiograms performed for evaluation of chest pain, murmur, or syncope. Real-time three-dimensional echocardiography was performed to evaluate LA reservoir, conduit, and booster pump function parameters. In addition to LA volume data, LV shortening fraction, spectral and tissue Doppler variables assessing diastolic function as well as myocardial performance index was obtained. Groups with and without AC therapy were compared by student t-test and chi-square test. We evaluated 136 patients, 55 (40.4%) had received AC. There was no significant difference between the groups in LV shortening fraction, diastolic as well as global function indices. LA reservoir and conduit function parameters were significantly lower in AC group compared to controls. The booster function parameters showed variable results. It is intriguing that AC-treated children have smaller LA reservoir and abnormal booster function. We speculate that these findings may reflect early changes in LA compliance associated with AC exposure. Assessment of LA volumes and function as prognostic markers of AC-induced cardiotoxicity in children is warranted.
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Affiliation(s)
- Dipika Menon
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Gilda Kadiu
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Yamuna Sanil
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sanjeev Aggarwal
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
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Tadic M, Genger M, Cuspidi C, Belyavskiy E, Frydas A, Dordevic A, Morris DA, Völkl J, Parwani AS, Pieske B, Haßfeld S. Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy. J Clin Med 2019; 8:jcm8040421. [PMID: 30934794 PMCID: PMC6518037 DOI: 10.3390/jcm8040421] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 12/24/2022] Open
Abstract
We aimed to explore left atrial (LA) remodeling in the patients with solid cancer before initiation of chemo- or radiotherapy. This retrospective investigation included 92 chemo- and radiotherapy-naive cancer patients and 40 age- and gender-matched controls with a similar cardiovascular risk profile as the cancer group. All participants underwent comprehensive echocardiographic examination before the start of chemo- or radiotherapy. LA phasic function was evaluated in volumetric and strain method. Indexed minimal and pre-A LA volumes were significantly higher in the cancer patients. Total and passive LA emptying fraction (EF) were significantly lower, whereas active LAEF was significantly higher in the cancer patients. LA total longitudinal strain was significantly lower in the cancer patients. Strain rate analysis of LA phasic function showed that LA function during systole and early diastole was reduced in the cancer group, while it was increased during late diastole. These findings indicated that LA reservoir and conduit functions, assessed with LA volumetric and strain analysis, were deteriorated in the cancer group. On the other hand, LA booster pump function was elevated in the cancer group in comparison with the controls. In the whole population, cancer was associated with reduced LA total longitudinal strain independently of age, gender, BMI, LV hypertrophy, E/e’ ratio, diabetes, and hypertension. LA phasic function was impaired in the chemo- and radiotherapy-naive cancer patients in comparison with the control group. Cancer, LV hypertrophy, and hypertension were associated with reduced LA longitudinal strain independently of other important clinical parameters.
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Affiliation(s)
- Marijana Tadic
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Martin Genger
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Cesare Cuspidi
- Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, 13353 Meda 20821, Italy.
| | - Evgeny Belyavskiy
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Athanasios Frydas
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Aleksandar Dordevic
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Daniel A Morris
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Jakob Völkl
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Abdul Shokor Parwani
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
- Deutsches Zentrum für Herz-Kreislauf-Forschung, Standort Berlin/Charité, 13353 Berlin, Germany.
- Department of Cardiology, Deutsches Herzzentrum Berlin, 13353 Berlin, Germany.
| | - Sabine Haßfeld
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
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Advanced Imaging of the Left Atrium with Cardiac Magnetic Resonance: A Review of Current and Emerging Methods and Clinical Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0303-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Patel NR, Chyu CK, Satou GM, Halnon NJ, Nguyen KL. Left atrial function in children and young adult cancer survivors treated with anthracyclines. Echocardiography 2018; 35:1649-1656. [DOI: 10.1111/echo.14100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nisha R. Patel
- Division of Cardiology; David Geffen School of Medicine at UCLA; and VA Greater Los Angeles Healthcare System; Los Angeles California
| | - Christopher K. Chyu
- Division of Pediatric Cardiology; Mattel Children's Hospital; David Geffen School of Medicine at UCLA; Los Angeles California
- Division of Pediatric Cardiology; Benioff Children's Hospital; University of California San Francisco; San Francisco California
| | - Gary M. Satou
- Division of Pediatric Cardiology; Mattel Children's Hospital; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Nancy J. Halnon
- Division of Pediatric Cardiology; Mattel Children's Hospital; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Kim-Lien Nguyen
- Division of Cardiology; David Geffen School of Medicine at UCLA; and VA Greater Los Angeles Healthcare System; Los Angeles California
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