Non-invasive evaluation of late cardiac toxicity in childhood cancer survivors. M. M. Hudson, S. N. Rai, X. Deng, T. Merchant, N. Marina, N. Zalamea, C. Cox, S. Phipps, D. Rosenthal; St. Jude Children's Research Hospital, Memphis, TN; Stanford University Medical Center, Stanford, CA Abstract: Background: Our understanding of the relationship of echocardiographic abnormalities to clinical cardiovascular status in long-term childhood cancer survivors is deficient. Methods: Long-term childhood cancer survivors returning for annual follow-up were assessed by physical examination, laboratory (hemoglobin, thyroid function, and fasting lipid profile) evaluation, echocardiogram, and 12-lead and 24-hour electrocardiogram. Mean fractional shortening (FS) and afterload (AF) were compared for survivors who did (at risk) and did not (no risk) receive cardiotoxic therapy and to control values. Two sample t test and multiple regression analysis were used to analyze data. Results: Of 278 survivors studied, 237 were at risk and 41 at no risk for cardiotoxicity. Median age at diagnosis and evaluation was 4.7 years and 16.8 years; 50% were male and 81.7% Caucasian. The median dose of anthracycline was 195 mg/m2. None of the patients had clinical cardiac dysfunction. Mean FS (SD) was lower for at risk survivors (0.334+0.062) compared to normative controls (0.36+0.04) (p<0.0001). Mean AF (SD) was higher for at risk survivors (56.67+20.58) compared to no risk survivors (46.49+14.82) and normative controls (48.0+13.0) (p<0.0001 and p=0.003, respectively). Multiple regression analyses showed that anthracycline dose (p=0.0003) and age at therapy (p=0.0154) predicted FS; these same parameters plus time from therapy and BMI were significant predictors of AF. Subjects treated with anthracycline dose > 260 mg/m2 were at highest risk for difference in FS and AF. Clinical cardiovascular status was not predictive of FS or AF. Conclusions: Childhood cancer survivors treated with anthracycline doses of > 260 mg/m2 are at greatest risk for abnormalities of FS and AF by non-invasive cardiac assessments. FS and AF were not correlated with clinical cardiac disease in this relatively young cohort. Abstract No: 6047 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.