Cardiotoxicity, Childhood Cancer
Conditions
Keywords
Echocardiography, Ventricular function, Stroke Volume
Brief summary
Longitudinal analysis of myocardial function using Speckle Tracking Echocardiography STE analysis and prediction of delayed toxic induced cardiomyopathy in young patients who received anthracycline therapy in childhood.
Detailed description
Anthracycline therapy may have short-, medium- or long-term cardiac toxicity that impacts patient's life. The main recognized risk factors for delayed cardiotoxicity are cumulative anthracycline dose, female gender, association with mediastinal radiotherapy and young age at administration. Prediction of delayed cardiotoxicity in children population is still challenging. The Speckle Tracking Echocardiography (STE) method, an innovative echocardiographic technique, analyses the myocardial displacement of natural acoustic markers via a software. The objective of the study is to analyze, in young patients who received anthracycline therapy in childhood, 5-years after their inclusion in the Speckle Anthra study and first STE results, the evolution of myocardial function using STE method.
Interventions
DIAGNOSTIC_TESTcardiac ultrasound with speckle tracking analysis
Experimental group: cardiac ultrasound with speckle tracking analysis done during a regular cardiac visit planned after receiving cardiotoxic chemotherapy in childhood. Control group: cardiac ultrasound with speckle tracking analysis done during a cardiac visit for minor symptoms (murmur, physical aptitude). Advocated Tomtec software will be used to make post-processing speckle tracking analysis based on 2D ultrasound cineloop acquired during a standard echocardiography.
Sponsors
University Hospital, Montpellier
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
11 Years to 27 Years
Healthy volunteers
Yes
Inclusion criteria
ANTHRA GROUP Inclusion Criteria: * Patients who were treated with anthracyclines for malignant disease between the ages of 0 and 18 * Patient aged 11 to 27 years * Included in the SpeckleAnthra Study (NCT02893787) * Discontinued chemotherapy for more than 6 years * Patient in remission of malignant disease * Enrolled in a social security plan * Written informed consent from at least one legal representative for the minor patient/ Written informed consent for patients of legal age
Exclusion criteria
* Onset of active malignancy or recurrence of malignancy after the Speckle Anthra study that required resumption of chemotherapy or mediastinal radiotherapy. * Chronic cardiac, pulmonary or muscular pathology of etiology other than secondary to anthracycline therapy * For adult patients: subject under guardianship or curators CONTROL GROUP Inclusion Criteria: * Control patient included in the Speckle Control study (NCT02056925) * Had a cardiological consultation with echocardiography performed for a banal reason (heart murmur test, cardiological symptoms) and whose result was normal * No chronic disease or long-term drug treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Left Ventricle Global Longitudinal 2D strain (LVGLS) expressed in percentage and obtained from cardiac ultrasound cineloop of 2D 4,3 and 2 apical views analyzed by the Tomtec STE Software. | 5 years | To compare the evolution at 5 years (Anthra2 study timeframe) of LVGLS obtained by STE analysis on patients treated with anthracyclines in childhood and previously included in first Speckle Anthra study, with the normal evolution of this parameter with age in healthy matched volunteers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Left Ventricle Ejection fraction (LVEF) by Simpson method (%) | The day of inclusion | Compare the standard ultrasound parameter LVEF and the LVGLS obtained in Speckle Anthra 2 on patients treated with anthracyclines in childhood and in the group of healthy volunteers. |
| Left ventricular myocardial dysfunction defined by LVEF < 55% | 5 years | Correlation between the left ventricular myocardial dysfunction is defined by FeVG \< 55% and the left global longitudinal 2D strain expressed in percentage and measured during the previous SpeckleAnthra study |
| Death secondary to toxic cardiomyopathy | 5 years | Correlation between the rate of patients died with a toxic cardiomyopathy and the left global longitudinal 2D strain expressed in percentage and measured during the previous SpeckleAnthra study |
Other
| Measure | Time frame | Description |
|---|---|---|
| Troponin T on the experimental group | The day of inclusion | Troponin T is a biological markers of cardiotoxicity obtained in a standard blood test analysis and expressed in ng/ml. normal troponin value is between 0 and 0.04 ng/mL |
| NT-pro-BNP on the experimental group | The day of inclusion | NT-pro-BNP (N terminal-pro-brain natriuretic peptides) is a biological markers of cardiotoxicity obtained in a standard blood test analysis and expressed in pg/ml. Normal NT-proBNP value is \< 400pg/ml |
| Known risk factors for cardiotoxicity | the day of inclusion | To assess the effect of known risk factors for anthracycline cardiotoxicity, the anthracycline cumulative dose will be collected |
Countries
France
Outcome results
None listed