Right Ventricular Function in long-term survivors of childhood acute Lymphoblastic Leukemia: from the CTOXALL study
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Author
Heredia, Gloria
González Manzanares, Rafael
Ojeda, Soledad
Molina, Juan Ramón
Fernández-Aviles, Consuelo
Hidalgo, F.
López Aguilera, José
Crespín Crespín, Manuel
Mesa, Dolores
Anguita, Manuel
Castillo, Juan C.
Pan, Manuel
Publisher
MDPIDate
2023Subject
Cardio-oncologyCardiotoxicity
Right ventricular strain
Echocardiography
Childhood cancer survivor
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There are limited data regarding right ventricle (RV) impairment in long-term survivors of childhood acute lymphoblastic leukemia (CLS). The aim of this study was to assess RV function in these patients using echocardiographic conventional measurements and automated RV strain. Echocardiographic recordings of 90 CLS and 58 healthy siblings from the CTOXALL cohort were analyzed. For group comparisons, inverse probability weighting was used to reduce confounding. The CLS group (24.6 ± 9.7 years, 37.8% women) underwent an echocardiographic evaluation 18 (11–26) years after the diagnosis. RV systolic dysfunction was found in 16.7% of CLS individuals using RV free-wall strain (RVFWS) compared to 2.2 to 4.4% with conventional measurements. RV systolic function measurements were lower in the CLS than in the control group: TAPSE (23.3 ± 4.0 vs. 25.2 ± 3.4, p = 0.004) and RVFWS (24.9 ± 4.6 vs. 26.8 ± 4.7, p = 0.032). Modifiable cardiovascular risk factors such as obesity (p = 0.022) and smoking (p = 0.028) were independently associated with reduced RVFWS. In conclusion, RV systolic function impairment was frequent in long-term survivors of childhood leukemia, underscoring the importance of RV assessment, including RVFWS, in the cardiac surveillance of these patients.