Left Ventricular Function Assessed by Two-Dimensional Speckle Tracking Echocardiography in Long-Term Survivors of Hodgkin's Lymphoma Treated by Mediastinal Radiotherapy With or Without Anthracycline Therapy

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• 作者：Huey-Ru Tsai MD^a ; ^b ; Ola Gjesdal MD ; PhD^a ; Torgeir Wethal MD^a ; Kristina Hermann Haugaa MD^a ; ^b ; Alexander Foss&#xe5 ; MD ; PhD^c ; Sophie Dorothea Foss&#xe5 ; MD ; PhD^d ; Thor Edvardsen MD ; PhD^a ; ^b ; ^{thor.edvardsen@medisin.uio.no}
• 刊名：The American Journal of Cardiology
• 出版年：2011
• 出版时间：1 February 2011
• 年：2011
• 卷：107
• 期：3
• 页码：472-477
• 全文大小：790 K

文摘

Anthracycline therapy is well known for its adverse cardiac effects. However, few studies have been performed of the long-term follow-up of myocardial function in adult survivors of Hodgkin's lymphoma receiving anthracycline. Two-dimensional speckle tracking echocardiography is an accurate angle-independent modality for the quantification of left ventricular (LV) function. The aim of the present study was to investigate the long-term effect of anthracycline on LV systolic function. Echocardiography was performed in 47 survivors of Hodgkin's lymphoma 22 ± 2 years after successful mediastinal radiotherapy with (n = 27) or without (n = 20) anthracycline (doxorubicin) treatment and in 20 healthy controls. LV function was assessed by the LV ejection fraction and global longitudinal and circumferential strain. Both patient groups had received a similar dosage of radiation, and doxorubicin was given at a total dose of 309 ± 92 mg. The global longitudinal strain was reduced in patients receiving anthracycline with mediastinal radiotherapy compared to the other group receiving mediastinal radiotherapy alone or combined radiotherapy and regimens without anthracyclines (−16.1 ± 1.9 % vs −17.5 ± 1.7 % , respectively, p <0.05). Both patient groups had reduced strain compared to the healthy controls (−20.4 ± 1.7 % , both p <0.001). The circumferential strain was also reduced in the treatment groups (−18.3 ± 3.2 % and −17.8 ± 3.6 % vs −22.5 ± 2.1 % , both p <0.001). The LV ejection fraction did not differ between the patient groups (55 ± 8 % vs 56 ± 6 % , p = 1.0) but was reduced compared to that of the controls (62 ± 5 % , both p <0.05). In conclusion, myocardial function was reduced in the survivors of Hodgkin's lymphoma 2 decades after successful treatment consisting of mediastinal radiotherapy with or without chemotherapy. Patients receiving anthracycline therapy had additional negative long-tem effects on LV systolic function.