Early detection of cardiac dysfunction using shear wave imaging: insights into reduced cardiorespiratory fitness in childhood cancer survivors

Early detection of cardiac dysfunction using shear wave imaging: insights into reduced cardiorespiratory fitness in childhood cancer survivors

Abstract Background Diastolic dysfunction is thought to be the earliest cardiotoxic sequel after cancer therapy among childhood cancer survivors. Despite many survivors do exhibit reduced cardiorespiratory fitness (CRF) potentially due to cardiotoxicity, current echocardiographic parameters fail to...

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Veröffentlicht in:European heart journal 2024-10, Vol.45 (Supplement_1)
Hauptverfasser: Youssef, A, Verschueren, S, Vanrusselt, D, Van Ermengem, N, Uyttebroeck, A, Hornickx, M, Pleysier, S, Wouters, L, Cools, B, D'hooge, J, Voigt, J U
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container_title European heart journal
container_volume 45
creator Youssef, A
Verschueren, S
Vanrusselt, D
Van Ermengem, N
Uyttebroeck, A
Hornickx, M
Pleysier, S
Wouters, L
Cools, B
D'hooge, J
Voigt, J U
description Abstract Background Diastolic dysfunction is thought to be the earliest cardiotoxic sequel after cancer therapy among childhood cancer survivors. Despite many survivors do exhibit reduced cardiorespiratory fitness (CRF) potentially due to cardiotoxicity, current echocardiographic parameters fail to detect hidden diastolic dysfunction early after therapy (1). High frame rate (HFR) shear wave imaging (SWI) is a novel tool that could give insights about myocardial stiffness, which is a key determining factor of diastolic function. Purpose We aimed at testing the ability of SWI to detect early alterations in myocardial stiffness among childhood cancer survivors and its relation with the reduced CRF. Methods Fifty childhood cancer survivors (mean 20 ±3 years) who received chemo-and/or- radiotherapy (mean time after treatment: 4 ±3 years) and thirty-two matched healthy volunteers (HV) were recruited. Conventional as well as HFR echocardiographic images (ca. 1200 frames/second) were acquired at rest using a modified commercial echocardiography machine. All participants underwent an incremental, symptom-limited cardiopulmonary exercise test on a treadmill measuring peak oxygen consumption (VO2 peak). HFR data were analysed offline. An anatomical M mode was drawn along the ventricular septum, and tissue Doppler acceleration maps were extracted to measure SW velocities after mitral valve closure (MVC) (Figure 1). Results Among cancer survivors, left ventricular ejection fraction (LVEF) and global longitudinal strain were significantly lower compared to HV (56 % ±4 vs 59 % ±4, and 17.6 % ±1.6 vs 19.1 % ±1.2, respectively; p 0.05). The mean SW velocities were significantly higher in cancer survivors compared to HV (3.9 ±0.6 m/s vs 3.2 ±0.3 m/s respectively; p
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Despite many survivors do exhibit reduced cardiorespiratory fitness (CRF) potentially due to cardiotoxicity, current echocardiographic parameters fail to detect hidden diastolic dysfunction early after therapy (1). High frame rate (HFR) shear wave imaging (SWI) is a novel tool that could give insights about myocardial stiffness, which is a key determining factor of diastolic function. Purpose We aimed at testing the ability of SWI to detect early alterations in myocardial stiffness among childhood cancer survivors and its relation with the reduced CRF. Methods Fifty childhood cancer survivors (mean 20 ±3 years) who received chemo-and/or- radiotherapy (mean time after treatment: 4 ±3 years) and thirty-two matched healthy volunteers (HV) were recruited. Conventional as well as HFR echocardiographic images (ca. 1200 frames/second) were acquired at rest using a modified commercial echocardiography machine. All participants underwent an incremental, symptom-limited cardiopulmonary exercise test on a treadmill measuring peak oxygen consumption (VO2 peak). HFR data were analysed offline. An anatomical M mode was drawn along the ventricular septum, and tissue Doppler acceleration maps were extracted to measure SW velocities after mitral valve closure (MVC) (Figure 1). Results Among cancer survivors, left ventricular ejection fraction (LVEF) and global longitudinal strain were significantly lower compared to HV (56 % ±4 vs 59 % ±4, and 17.6 % ±1.6 vs 19.1 % ±1.2, respectively; p &lt;0.001). However, both LVEF and GLS were within the normal range and none of them correlated with the peak VO2 (Figure 2A&amp;B). None of the echocardiographic diastolic parameters (e.g. mitral E, E/e’, left atrial volume or TR jet velocity) showed significant difference between both groups (P &gt; 0.05). The mean SW velocities were significantly higher in cancer survivors compared to HV (3.9 ±0.6 m/s vs 3.2 ±0.3 m/s respectively; p &lt;0.001). Interestingly, SW velocities among cancer survivors showed moderate significant negative correlation with the VO2 peak (r= -0.590, p &lt;0.001) indicating increasing myocardial stiffness as the cardiorespiratory fitness declined (Figure 2C). Conclusions Our data indicate that myocardial stiffness in cancer survivors is significantly increased. We hypothesize that this increased stiffness may at least in part explain the significantly reduced cardiorespiratory fitness in this population. Echocardiographic shear wave elastography appears as a promising non-invasive tool for early detection of diastolic dysfunction in follow-up of childhood cancer survivors.Figure 1.Figure 2.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehae666.148</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>European heart journal, 2024-10, Vol.45 (Supplement_1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Youssef, A</creatorcontrib><creatorcontrib>Verschueren, S</creatorcontrib><creatorcontrib>Vanrusselt, D</creatorcontrib><creatorcontrib>Van Ermengem, N</creatorcontrib><creatorcontrib>Uyttebroeck, A</creatorcontrib><creatorcontrib>Hornickx, M</creatorcontrib><creatorcontrib>Pleysier, S</creatorcontrib><creatorcontrib>Wouters, L</creatorcontrib><creatorcontrib>Cools, B</creatorcontrib><creatorcontrib>D'hooge, J</creatorcontrib><creatorcontrib>Voigt, J U</creatorcontrib><title>Early detection of cardiac dysfunction using shear wave imaging: insights into reduced cardiorespiratory fitness in childhood cancer survivors</title><title>European heart journal</title><description>Abstract Background Diastolic dysfunction is thought to be the earliest cardiotoxic sequel after cancer therapy among childhood cancer survivors. Despite many survivors do exhibit reduced cardiorespiratory fitness (CRF) potentially due to cardiotoxicity, current echocardiographic parameters fail to detect hidden diastolic dysfunction early after therapy (1). High frame rate (HFR) shear wave imaging (SWI) is a novel tool that could give insights about myocardial stiffness, which is a key determining factor of diastolic function. Purpose We aimed at testing the ability of SWI to detect early alterations in myocardial stiffness among childhood cancer survivors and its relation with the reduced CRF. Methods Fifty childhood cancer survivors (mean 20 ±3 years) who received chemo-and/or- radiotherapy (mean time after treatment: 4 ±3 years) and thirty-two matched healthy volunteers (HV) were recruited. Conventional as well as HFR echocardiographic images (ca. 1200 frames/second) were acquired at rest using a modified commercial echocardiography machine. All participants underwent an incremental, symptom-limited cardiopulmonary exercise test on a treadmill measuring peak oxygen consumption (VO2 peak). HFR data were analysed offline. An anatomical M mode was drawn along the ventricular septum, and tissue Doppler acceleration maps were extracted to measure SW velocities after mitral valve closure (MVC) (Figure 1). Results Among cancer survivors, left ventricular ejection fraction (LVEF) and global longitudinal strain were significantly lower compared to HV (56 % ±4 vs 59 % ±4, and 17.6 % ±1.6 vs 19.1 % ±1.2, respectively; p &lt;0.001). However, both LVEF and GLS were within the normal range and none of them correlated with the peak VO2 (Figure 2A&amp;B). None of the echocardiographic diastolic parameters (e.g. mitral E, E/e’, left atrial volume or TR jet velocity) showed significant difference between both groups (P &gt; 0.05). The mean SW velocities were significantly higher in cancer survivors compared to HV (3.9 ±0.6 m/s vs 3.2 ±0.3 m/s respectively; p &lt;0.001). Interestingly, SW velocities among cancer survivors showed moderate significant negative correlation with the VO2 peak (r= -0.590, p &lt;0.001) indicating increasing myocardial stiffness as the cardiorespiratory fitness declined (Figure 2C). Conclusions Our data indicate that myocardial stiffness in cancer survivors is significantly increased. We hypothesize that this increased stiffness may at least in part explain the significantly reduced cardiorespiratory fitness in this population. Echocardiographic shear wave elastography appears as a promising non-invasive tool for early detection of diastolic dysfunction in follow-up of childhood cancer survivors.Figure 1.Figure 2.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqNkE1qwzAQhUVpoWnaIxR0ASeSLI_t7kpIfyDQTRbdGUUaxQqpFSQ7xZfomWvj0HVXMzzee8N8hDxytuCsTJfYhRpVaA9LrBUCwILL4orMeCZEUoLMrsmM8TJLAIrPW3IX44ExVgCHGflZq3DsqcEWdet8Q72lWgXjlKamj7ZrJrmLrtnTON6h3-qM1H2p_SA9UddEt6_bOCytpwFNp9FMHT5gPLmgWh96al3bYBxtVNfuaGrvR1ujMdDYhbM7-xDvyY1Vx4gPlzkn25f1dvWWbD5e31fPm0QXeZGkbIe5lEpLsLizWnK0AiBjsMsLJlQuOHArUixVDkqzUoBhiJiyMje5kOmcZFOtDj7GgLY6heGh0FecVSPT6o9pdWFaDUyHHJtyvjv9M_IL5f2EHQ</recordid><startdate>20241028</startdate><enddate>20241028</enddate><creator>Youssef, A</creator><creator>Verschueren, S</creator><creator>Vanrusselt, D</creator><creator>Van Ermengem, N</creator><creator>Uyttebroeck, A</creator><creator>Hornickx, M</creator><creator>Pleysier, S</creator><creator>Wouters, L</creator><creator>Cools, B</creator><creator>D'hooge, J</creator><creator>Voigt, J U</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20241028</creationdate><title>Early detection of cardiac dysfunction using shear wave imaging: insights into reduced cardiorespiratory fitness in childhood cancer survivors</title><author>Youssef, A ; Verschueren, S ; Vanrusselt, D ; Van Ermengem, N ; Uyttebroeck, A ; Hornickx, M ; Pleysier, S ; Wouters, L ; Cools, B ; D'hooge, J ; Voigt, J U</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c878-30be744ac46febfc41ef266506b7802a72161f23e9a76ac0926d0eee3097d7243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Youssef, A</creatorcontrib><creatorcontrib>Verschueren, S</creatorcontrib><creatorcontrib>Vanrusselt, D</creatorcontrib><creatorcontrib>Van Ermengem, N</creatorcontrib><creatorcontrib>Uyttebroeck, A</creatorcontrib><creatorcontrib>Hornickx, M</creatorcontrib><creatorcontrib>Pleysier, S</creatorcontrib><creatorcontrib>Wouters, L</creatorcontrib><creatorcontrib>Cools, B</creatorcontrib><creatorcontrib>D'hooge, J</creatorcontrib><creatorcontrib>Voigt, J U</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Youssef, A</au><au>Verschueren, S</au><au>Vanrusselt, D</au><au>Van Ermengem, N</au><au>Uyttebroeck, A</au><au>Hornickx, M</au><au>Pleysier, S</au><au>Wouters, L</au><au>Cools, B</au><au>D'hooge, J</au><au>Voigt, J U</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early detection of cardiac dysfunction using shear wave imaging: insights into reduced cardiorespiratory fitness in childhood cancer survivors</atitle><jtitle>European heart journal</jtitle><date>2024-10-28</date><risdate>2024</risdate><volume>45</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background Diastolic dysfunction is thought to be the earliest cardiotoxic sequel after cancer therapy among childhood cancer survivors. Despite many survivors do exhibit reduced cardiorespiratory fitness (CRF) potentially due to cardiotoxicity, current echocardiographic parameters fail to detect hidden diastolic dysfunction early after therapy (1). High frame rate (HFR) shear wave imaging (SWI) is a novel tool that could give insights about myocardial stiffness, which is a key determining factor of diastolic function. Purpose We aimed at testing the ability of SWI to detect early alterations in myocardial stiffness among childhood cancer survivors and its relation with the reduced CRF. Methods Fifty childhood cancer survivors (mean 20 ±3 years) who received chemo-and/or- radiotherapy (mean time after treatment: 4 ±3 years) and thirty-two matched healthy volunteers (HV) were recruited. Conventional as well as HFR echocardiographic images (ca. 1200 frames/second) were acquired at rest using a modified commercial echocardiography machine. All participants underwent an incremental, symptom-limited cardiopulmonary exercise test on a treadmill measuring peak oxygen consumption (VO2 peak). HFR data were analysed offline. An anatomical M mode was drawn along the ventricular septum, and tissue Doppler acceleration maps were extracted to measure SW velocities after mitral valve closure (MVC) (Figure 1). Results Among cancer survivors, left ventricular ejection fraction (LVEF) and global longitudinal strain were significantly lower compared to HV (56 % ±4 vs 59 % ±4, and 17.6 % ±1.6 vs 19.1 % ±1.2, respectively; p &lt;0.001). However, both LVEF and GLS were within the normal range and none of them correlated with the peak VO2 (Figure 2A&amp;B). None of the echocardiographic diastolic parameters (e.g. mitral E, E/e’, left atrial volume or TR jet velocity) showed significant difference between both groups (P &gt; 0.05). The mean SW velocities were significantly higher in cancer survivors compared to HV (3.9 ±0.6 m/s vs 3.2 ±0.3 m/s respectively; p &lt;0.001). Interestingly, SW velocities among cancer survivors showed moderate significant negative correlation with the VO2 peak (r= -0.590, p &lt;0.001) indicating increasing myocardial stiffness as the cardiorespiratory fitness declined (Figure 2C). Conclusions Our data indicate that myocardial stiffness in cancer survivors is significantly increased. We hypothesize that this increased stiffness may at least in part explain the significantly reduced cardiorespiratory fitness in this population. Echocardiographic shear wave elastography appears as a promising non-invasive tool for early detection of diastolic dysfunction in follow-up of childhood cancer survivors.Figure 1.Figure 2.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehae666.148</doi></addata></record>
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