Abstract 2435: The Role of Myocardial Longitudinal Strain in Monitoring Subclinical Heart Failure in Survivors of Childhood Cancer

Abstract

Objectives: Previous studies have demonstrated that myocardial longitudinal strain and strain rate is decreased in asymptomatic patients treated with anthracyclines. In this study, the relation between global myocardial longitudinal strain, conventional echocardiographic parameters, NT-pro-BNP levels, cumulative anthracycline dosage and follow up duration was investigated in a large group of asymptomatic long term survivors of childhood cancer. Methods: 79 asymptomatic survivors (45% children) underwent a detailed echocardiographic examination for obtaining conventional parameters and global myocardial longitudinal strain values in 4-chamber view. In addition to this, we collected blood samples for NT-pro-BNP estimation. Results: the survivors had a mean age of 20 years (range: 6 –37 years), a mean follow up duration of 14 years (range 5–27 years) and a mean cumulative anthracycline dose of 240 mg/m 2 (range 50 –524 mg/m 2 ). Reduced global myocardial longitudinal strain was significantly related to an EF<55% (p<0.001) and to reduced left ventricular posterior wall thickness in diastole indexed by body surface area (LVPWd/BSA) (p<0.003). Reduced myocardial global longitudinal strain was not related to abnormal NT-pro-BNP levels, follow up duration and cumulative anthracycline dosage. Conclusion: reduced global myocardial longitudinal strain is related to subclinical heart failure, e.g. abnormal EF and reduced LVPWd/BSA in asymptomatic survivors of childhood cancer. The role of myocardial strain in the early detection of anthracycline-induced cardiotoxicity needs to be explored by further longitudinal prospective studies.