Journal article
Electrophysiological effects of anthracyclines in adult survivors of pediatric malignancy
Pediatric blood & cancer, Vol.64(11), pp.e26556-n/a
11/01/2017
DOI: 10.1002/pbc.26556
PMID: 28453898
Abstract
Background: Anthracycline use is limited by cardiotoxicity, including arrhythmias and left ventricular (LV) dysfunction. We aim to characterize the association between electrophysiological changes and LV dysfunction.
Methods: A retrospective chart review was conducted, including all 147 pediatric cancer survivors at our institution over 18 years of age and treated with an anthracycline. One hundred thirty-four patients who had at least one electrocardiogram (ECG) and echocardiogram were analyzed. The association between dysfunction and baseline characteristics, treatment history, and electrocardigraphic parameters were analyzed using multivariable logistic regression. Additionally, a longitudinal generalized estimating equation (GEE) model was used to examine the temporal association between repeated measure corrected QT (QTc) intervals and subsequent LV function.
Results: In our population, 24% of patients had LV dysfunction. The initial posttreatment QTc interval was longer in patients with LV dysfunction (438 35 vs. 420 +/- 20 msec, P = 0.002). In logistic regression analysis, QTc interval (P < 0.001) and cumulative radiation dose (P = 0.027) were associated with LV dysfunction. On ECGs performed prior to evidence of LV dysfunction, the QTc was longer than on ECGs preceding a normal echocardiogram (451 +/- 32 msec vs. 423 +/- 25 msec, P < 0.001). Mean time from QTc 450 msec to evidence of LV dysfunction was 1.8 +/- 2.9 years. In the longitudinal GEE model, QTc prolongation was associated with subsequent decreased fractional shortening.
Conclusions: Among adult survivors of pediatric cancer treated with anthracyclines, prolongation of the QTc interval was associated with subsequent LV dysfunction.
Details
- Title: Subtitle
- Electrophysiological effects of anthracyclines in adult survivors of pediatric malignancy
- Creators
- Timothy M. Markman - Johns Hopkins UniversityKathryn Ruble - Johns Hopkins UniversityDavid Loeb - Johns Hopkins UniversityAllen Chen - Johns Hopkins UniversityYiyi Zhang - Johns Hopkins UniversityGary S. Beasley - Johns Hopkins UniversityW. Reid Thompson - Johns Hopkins UniversitySaman Nazarian - Johns Hopkins University
- Resource Type
- Journal article
- Publication Details
- Pediatric blood & cancer, Vol.64(11), pp.e26556-n/a
- Publisher
- Wiley
- DOI
- 10.1002/pbc.26556
- PMID
- 28453898
- ISSN
- 1545-5009
- eISSN
- 1545-5017
- Number of pages
- 6
- Grant note
- Biosense-Webster Inc.
- Language
- English
- Date published
- 11/01/2017
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984354009902771
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