BACKGROUND The aim of this study was to test the hypothesis that left ventricular (LV) and right ventricular (RV) functional reserves are altered in anthracycline-treated long-term survivors of childhood cancers. METHODS One hundred three survivors (55% men) aged 25.0 ± 5.8 years at 15.2 ± 5.8 years after chemotherapy and 61 healthy control subjects (52% men) were studied. Tissue Doppler-derived mitral and tricuspid systolic (s) and early diastolic (e) velocities and LV myocardial acceleration during isovolumic contraction (IVA) were determined at rest and during bicycle exercise. The slope of the LV force-frequency relationship was derived from changes in IVA with heart rate during exercise (ΔIVA/Δ[heart rate]). LV and RV functional reserves were further assessed by the systolic functional reserve index (Δs × [1 - 1/s at baseline]) and diastolic functional reserve index (Δe × [1 - 1/e at baseline]). RESULTS At baseline, mitral annular tissue Doppler indices were similar between survivors and control subjects (P > .05 for all), while tricuspid s and e velocities were significantly lower in survivors (P < .05 for both). The force-frequency relationship slope (P < .001), LV systolic functional reserve index (P < .001), and RV systolic functional reserve index (P = .001) were significantly lower in survivors than control subjects. For diastolic functional reserve, LV but not RV diastolic functional reserve index was significantly lower in survivors (P < .001). Multivariate analysis revealed survivor status (β = -0.39, P < .001) and baseline LV IVA (β = 0.15, P < .044) as significant determinants of the LV force-frequency relationship. CONCLUSIONS LV and RV functional reserves during exercise are impaired in anthracycline-treated long-term survivors of childhood cancer.

中文翻译：

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在蒽环类药物治疗的儿童癌症长期幸存者中，左右心室收缩和舒张功能储备受到损害。

背景技术本研究的目的是检验在蒽环类药物治疗的儿童癌症长期幸存者中左心室（LV）和右心室（RV）功能储备发生改变的假设。方法研究了化疗后15.2±5.8年的25.0±5.8岁的100名幸存者（55％男性）和61名健康对照者（52％男性）。在休息和骑自行车运动期间，确定组织多普勒衍生的二尖瓣和三尖瓣收缩期和舒张早期期速度以及等容收缩（IVA）期间的左心室心肌加速。LV力频率关系的斜率来自运动中IVA随心率的变化（ΔIVA/Δ[心率]）。左室和右室功能储备进一步由收缩功能储备指数（基线时的Δs×[1-1 / s]）和舒张功能储备指数（基线时的Δe×[1-1 / e]）进行评估。结果在基线时，幸存者和对照组之间的二尖瓣环组织多普勒指数相似（所有P均> 0.05），而三尖瓣的s和e速度显着低于幸存者（两者P均<0.05）。幸存者的力频关系斜率（P <.001），LV收缩功能储备指数（P <.001）和RV收缩功能储备指数（P = .001）显着低于对照组。对于舒张期功能储备，幸存者的左室舒张功能储备指数明显低于左室舒张功能储备指数（P <.001）。多变量分析显示幸存者状态（β= -0.39，P <。001）和基线LV IVA（β= 0.15，P <.044）作为LV力-频率关系的重要决定因素。结论在蒽环类药物治疗的儿童癌症长期幸存者中，运动过程中的LV和RV功能储备受到损害。