Abstract 20066: Reduced Left Ventricular Function in Hodgkin's Lymphoma Long-Term Survivors After Anthracycline Chemotherapy- A Two-Dimensional Speckle Tracking Echocardiographic Study
Introduction: Anthracycline therapy is well known for its cardiac adverse effects. There are, however, few studies for long-term follow-up of left ventricular (LV) function in adult Hodgkin's lymphoma survivors receiving anthracycline. Two-dimensional speckle tracking echocardiography (2D-STE) is an accurate angle-independent modality for quantification of LV function. We hypothesized that anthracycline administered 20 years ago may Results in reduced LV function that could be detected by 2D-STE.
Methods: Echocardiography was performed in 47 Hodgkin's lymphoma survivors 22±2 years following successful mediastinal radiotherapy with (n=27) or without (n=20) anthracycline treatment, and in 20 healthy controls. LV function was assessed by LV ejection fraction (EF) and global longitudinal strain, calculated as the average of peak systolic strain by 2D-STE in a 16-segment LV model.
Results: The two patient groups received similar dosage of radiation (41±3Gy vs. 41±1Gy, ns). Patients with anthracycline (doxorubicin) treatment received a total dose of 309±92 mg. Global longitudinal strain was reduced in patients receiving anthracycline with mediastinal radiotherapy compared to those receiving mediastinal radiotherapy alone or combined radiotherapy and regimens without anthracycline (−16.1±1.9% vs. −17.5±1.7%, p<0.05). Both patient groups had reduced strain compared to healthy controls (−20.4±1.7%, both p<0.05). LVEF could not differ between the two patient groups (55±8% vs. 56±6%, ns), but both groups had reduced function compared to controls (62±5%, both p<0.05).
Conclusions: Myocardial function was reduced in Hodgkin's lymphoma survivors two decades after successful treatment consisting of mediastinal radiotherapy with or without additional chemotherapy, indicating irreversible myocardial impairment. Despite so-called safe doses of anthracycline administered 20 years ago, patients receiving anthracycline had additional negative long-term effect on LV function.
- © 2010 by American Heart Association, Inc.