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The role of dobutamine stress echocardiography in early diagnosis of cardiac toxicity in long-term survivors of asymptomatic children treated with anthracycline

Author(s): Ayşe Yıldırım | F. Sedef Tunaoğlu | Faruk Güçlü Pınarlı | Mustafa İlhan | Aynur Oğuz | Ceyda Karadeniz | Rana Olguntürk | Deniz Oğuz | Serdar Kula

Journal: Anadolu Kardiyoloji Dergisi
ISSN 1302-8723

Volume: 10;
Issue: 02;
Start page: 154;
Date: 2010;
Original page

Keywords: Childhood cancer | dobutamine stress echocardiography | late cardiotoxicity | anthracycline

Objective: Long-term survivors of asymptomatic children treated with anthracycline may have cardiac toxicity without clinical findings. The subclinical cardiac toxicity could be evaluated by dobutamine stress echocardiography (DSE) with exploring effective and safe doses of dobutamine.Methods: Twenty asymptomatic survivors (mean age: 19.2±4.0 years) treated with cumulative dose of 282.1±125.9 mg/m2 of anthracycline were compared with 18 age-matched healthy volunteers. Total time completed this treatment was 10.2±2.2 years. This was a cross-sectional case-controlled study and patient and control groups were evaluated at the time of routine appointments. Echocardiographic studies were performed before and after each dobutamine infusion of 5, 10, 15, 20µg/kg/min. Statistical analysis: Mann-Whitney U test was used to evaluate the difference between the groups. ANOVA for repeated measurements test was used to compare each measurement of control and patients groups and Bonferroni posthoc test was used for correction.Results: Hemodynamic changes are observed at the dobutamine doses of 15µg/kg/min in the patient group. Before dobutamine infusion in the patient group only isovolumic relaxation and contraction times values were prolonged comparing to the control group. After the infusion of dobutamine ejection fraction, shortening fraction, left ventricular posterior wall thickening (%LVPWt), end-systolic wall stress (ESS), interventricular septum systolic thickening, left ventricular end-systolic and end-diastolic diameters, mitral acceleration (AT) and deceleration times values were deteriorated in the patient group compared to the control group (p

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