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Evaluation of cardiac function by tissue Doppler imaging in children with cancer

Korean Journal of Pediatrics 2006;49(4):417-423.
Published online April 15, 2006.
Evaluation of cardiac function by tissue Doppler imaging in children with cancer
Yeo Hyang Kim
Department of Pediatrics, School of Medicine, Keimyung University, Taegu, Korea
Tissue Doppler imaging을 이용한 소아 종양 환자에서의 심기능 평가
김여향
계명대학교 의과대학 소아과학교실
Correspondence: 
Yeo Hyang Kim, Email: kimyh@dsmc.or.kr
Abstract
Purpose
: The objectives of this study were to assess ventricular function by tissue Doppler imaging in children who were receiving chemotherapy or who had received chemotherapy, and to apply repeated tissue Doppler imaging to make an early assessment in cardiac toxicity studies.
Methods
: This study was conducted on 23 oncology patients on-treatment or off-treatment from April 2005 to July 2005 at Dongsan Medical Center, Keimyung University. All patients(group 1) were divided into two groups, fractional shortening(FS) over 29 percent(group 2) and FS under 28 percent (group 3) in the first category. These same patients were also divided into the following groups : group treated with anthracyclin(group 4) and group treated without anthracyclin(group 5). Deceleration time(DT), isovolumic relaxation time(IVRT), FS, peak early diastolic(E), and peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic(Sm), peak early diastolic(Em), and peak late diastolic(Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated a modified Tei index, E/A, E/Em ratio by using measured values.
Results
: Twenty three patients were enrolled : 12 boys and 11 girls. The average age of patients was 8 years and 4 months. Thirteen out of 23 patients were in the group treated with anthracyclin (group 4) and 6 had FS under 28 percent(group 3). E/Em ratio showed a significant difference between group 1 and control group(6.46¡¾1.85 vs 7.06¡¾1.64, P<0.05). Other parameters had no difference statistically.
Conclusion
: This study showed that the change of cardiac function developed earlier in diastolic function than in systolic function, as E/Em ratio reflecting the mean LV diastolic pressure showed a significant difference between the control group and chemotherapy groups. Echocardiography using tissue Doppler imaging is a non-invasive, comfortable and reliable method for post-chemotherapy follow up.
Key Words: Anthracyclin , Tissue Doppler imaging , Ventricular function


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