VIEW AN ABSTRACT

Background: Pulsed-wave tissue doppler echocardiography (PW-TDI) of mitral annular motion has been currently used in the assessment of left ventricular longitudinal function in the variety of myocardial diseases.
Objective:To evaluate the utility of PW-TDI for early detection of late myocardial damage in patients treated for malignancy in childhood
Patients: 72 patients in long term remission of the malignancy at the average age of 15±3 were examined. The average follow-up period of the patients after the treatment was 11±3yrs.The control group consisted of 70 healthy volunteers at the average age of 15±2yrs.
Methods: Left ventricular ejection fraction (LVEF) was assessed by Simpson’s rule. Maximal systolic velocity (Smax) of the motion of lateral and medial aspect of mitral annulus (MA) was assessed by means of PW-TDI and the average Smean value was calculated.
Results: No significant difference in LVEF was observed between the groups.Smax of the septal aspect of MA was significantly lower than that of the lateral aspect of MA in both the groups.Both Smax and Smean values were significantly lower in the group of patients as compared with the control group.50(69%) patients received anthracyclines as a part of the therapy,while 22(31%) patients did not. Both of the groups of patients significantly differed  neither in LVEF nor Smax and Smean values..No correlation was observed between S values and cumulative dose of anthracyclines or follow-up period in the patients.
Conclusions:The results reported support the utility of left ventricle longitudinal function assessment using PW-TDI in early detection of late myocardial injury.Left ventricular longitudinal function is significantly diminished in the patients despite normal values of LVEF.Surprisingly, the results show that anthracycline therapy is unlikely to determine the late toxicity of chemotherapy.