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Anthracycline Treatment and Left Atrial Function in Children: A Real-Time 3-Dimensional Echocardiographic Study

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Abstract

Anthracycline (AC) therapy is associated with left ventricular (LV) dysfunction. Left atrial (LA) size and function are used to assess LV diastolic function in heart failure in adults. Data on LA size and function following AC therapy in children is limited. We hypothesized that LA size and function will be abnormal in children following AC chemotherapy. This retrospective review included patients who received AC for pediatric cancers. Controls had normal echocardiograms performed for evaluation of chest pain, murmur, or syncope. Real-time three-dimensional echocardiography was performed to evaluate LA reservoir, conduit, and booster pump function parameters. In addition to LA volume data, LV shortening fraction, spectral and tissue Doppler variables assessing diastolic function as well as myocardial performance index was obtained. Groups with and without AC therapy were compared by student t-test and chi-square test. We evaluated 136 patients, 55 (40.4%) had received AC. There was no significant difference between the groups in LV shortening fraction, diastolic as well as global function indices. LA reservoir and conduit function parameters were significantly lower in AC group compared to controls. The booster function parameters showed variable results. It is intriguing that AC-treated children have smaller LA reservoir and abnormal booster function. We speculate that these findings may reflect early changes in LA compliance associated with AC exposure. Assessment of LA volumes and function as prognostic markers of AC-induced cardiotoxicity in children is warranted.

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  1. Division of Pediatric Cardiology, Department of Pediatrics, The Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA

    Dipika Menon, Gilda Kadiu, Yamuna Sanil & Sanjeev Aggarwal

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  1. Dipika Menon
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  2. Gilda Kadiu
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All authors affirm that each has made a significant contribution to the article and have participated in the concept and design, analysis and interpretation of data, drafting or revising of the manuscript, and they have approved the manuscript as submitted.

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Menon, D., Kadiu, G., Sanil, Y. et al. Anthracycline Treatment and Left Atrial Function in Children: A Real-Time 3-Dimensional Echocardiographic Study. Pediatr Cardiol 43, 645–654 (2022). https://doi.org/10.1007/s00246-021-02769-w

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