Abstract 426: Longitudinal Myocardial Strain and Strain Rate in Monitoring Subclinical Heart Failure in Asymptomatic Long-Term Survivors of Childhood Cancer
Objectives: In this study, we aim to determine the role of longitudinal myocardial strain (SL) and strain rate (SrL) in monitoring subclinical heart failure, in relation to conventional echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and clinical parameters such as cumulative anthracycline dosage (CAD) and follow-up duration in a large group of long-term survivors of childhood cancer.
Methods: 111 asymptomatic survivors of childhood cancer underwent a detailed echocardiography for obtaining conventional echocardiographic parameters and strain measurements. Blood samples were taken to determine the levels of NT-pro-BNP.
Results: Survivors were treated with a median CAD of 180 mg/m2 (range: 50 – 600) and median follow duration of 13 years (range: 5–30). Decreased global SL was significantly related to a decreased FS, EF, LVPWd/BSA and IVSd/BSA (p<0.002, p<0.001, p<0.001, p<0.02 respectively). The time to the peak global SL was significantly longer with decreased LVM/BSA and increased LVIDd/BSA (p<0.01 and p<0.01 respectively). Decreased global longitudinal strain rate (global SrL) was significantly related to decreased EF (p<0.01), smaller LVIDd/BSA (p<0.001), decreased LVPWd/BSA (p<0.001), decreased IVSd/BSA (p<0.002) and increased IVRT (p<0.001). No correlation was found between global S(r)L and NT-pro-BNP, CAD or follow-up duration.
Conclusion: This study showed that decreased global SL, global SrL and increased time to the peak global SL were significantly related to several known conventional echocardiographic parameters which are often affected in anthracycline-induced cardiotoxicity. The role of myocardial strain in the early detection of anthracycline-induced cardiotoxicity needs to be explored in further longitudinal prospective studies.