Anthracycline-induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in young adults in post-lymphoma remission - DUMAS - Dépôt Universitaire de Mémoires Après Soutenance
Mémoires Année : 2023

Anthracycline-induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in young adults in post-lymphoma remission

Résumé

Background: the cardiac-induced toxicity of chemotherapy including anthracycline is well-described in childhood lymphoma survivors (CLS). Objective: myocardial work (MW) is a new echocardiographic tool with a high sensibility to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracycline by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in CLS. Methods: thirty-one young adults including 16 CLS and 15 age-matched healthy controls were enrolled in the study. All underwent a resting echocardiography including an evaluation of left ventricular (LV) morphology and regional myocardial function. We assessed LV longitudinal (differentiating sub-endocardial and sub-epicardial layers), circumferential strains and twist, LV myocardial regional strains and MW. LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain and from myocardial wasted work (MWW) and myocardial work efficiency (MWE). Results: the longitudinal strains both at the level of the sub-endocardium and sub-epicardium was reduced in CLS compared to controls. The global MW index (MWI) was also decreased (1668±266 vs 1870±264%.mmHg in CLS patients and controls, respectively, P<0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. However, MWW and MWE remained unchanged compared to controls. Conclusion: our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in longitudinal strains and MW and an increase in LV mechanical dispersion. Specific alteration of the apex is present, but its causes and its clinical significance remain to be explored.
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Dates et versions

dumas-04088581 , version 1 (04-05-2023)

Identifiants

  • HAL Id : dumas-04088581 , version 1

Citer

Mohamed Jaber. Anthracycline-induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in young adults in post-lymphoma remission. Human health and pathology. 2023. ⟨dumas-04088581⟩
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