Subclinical anthracycline‐induced cardiotoxicity in long‐term follow‐up of asymptomatic childhood cancer survivors: Assessment by speckle tracking echocardiography

Objective Survivors of childhood cancer treated with anthracyclines carry the risk for developing late‐onset cardiotoxicity. The purpose of this study was to evaluate left ventricular ( LV ) function in this patient group and compare it with healthy controls by means of conventional and speckle tracking echocardiography ( STE ) after exposure to chemotherapy. Material and methods Conventional and STE were performed in 45 childhood cancer survivors (mean age 11 ± 4.6; 26 male) treated with anthracyclines (median cumulative dosage 240 mg/m 2 ; range, 100–460) and compared with age, gender and body surface area matched healthy controls. Follow‐up period after chemotherapy was 21.9 ± 17.8 months. Blood samples were taken from survivors and controls to determine brain natriuretic peptide ( BNP ). Results Following anthracycline exposure, pediatric cancer survivors had lower longitudinal, radial anteroseptal, and radial anterior strain values compared to controls ( P < .05). The calculated global longitudinal and global radial strain values were lower compared to the control group ( P < .05). Both groups had normal ejection fraction ( EF ) and fractional shortening ( FS ). Brain natriuretic peptide ( BNP ) levels of both groups were in the normal range. Conclusion Despite normal EF and FS , children exposed to anthracycline therapy may have late‐onset subtle changes of LV strain values measured by STE . Whether these changes of strain can predict future risk of developing heart failure needs to be explored in further studies.