Table 4.
Associations Between Increased Biomarkers Measured in the Last 90 Days of Doxorubicin Treatment and Echocardiographic Outcomes 4 Years Later in 156 Doxorubicin-Treated Children With High-Risk Acute Lymphoblastic Leukemia
| Left Ventricular Characteristic | Mean Z Score | SE | P v 0 | P for Equal Means |
|---|---|---|---|---|
| Fractional shortening | ||||
| Increased cTnT* | −1.04 | 0.33 | .001 | |
| Normal cTnT | −0.81 | 0.24 | .001 | .59 |
| Mass | ||||
| Increased cTnT | −1.02 | 0.21 | < .001 | |
| Normal cTnT | −0.81 | 0.17 | < .001 | .45 |
| End-diastolic dimension | ||||
| Increased cTnT | 0.06 | 0.18 | .73 | |
| Normal cTnT | 0.06 | 0.20 | .78 | .67 |
| End-systolic dimension | ||||
| Increased cTnT | 0.54 | 0.24 | .02 | |
| Normal cTnT | 0.33 | 0.20 | .10 | .50 |
| End-diastolic posterior wall thickness | ||||
| Increased cTnT | −1.12 | 0.26 | < .001 | |
| Normal cTnT | −0.86 | 0.18 | < .001 | .38 |
| Thickness-to-dimension ratio | ||||
| Increased cTnT | −1.02 | 0.27 | < .001 | |
| Normal cTnT | −0.61 | 0.20 | .002 | .20 |
| Fractional shortening | ||||
| Increased NT-proBNP† | −0.97 | 0.23 | < .001 | |
| Normal NT-proBNP | −0.66 | 0.30 | .033 | .40 |
| Mass | ||||
| Increased NT-proBNP | −0.93 | 0.14 | < .001 | |
| Normal NT-proBNP | −0.53 | 0.37 | .15 | .32 |
| End-diastolic dimension | ||||
| Increased NT-proBNP | 0.01 | 0.16 | .97 | |
| Normal NT-proBNP | −0.46 | 0.30 | .13 | .14 |
| End-systolic dimension | ||||
| Increased NT-proBNP | 0.46 | 0.18 | .01 | |
| Normal NT-proBNP | −0.03 | 0.32 | .93 | .16 |
| End-diastolic posterior wall thickness | ||||
| Increased NT-proBNP | −0.92 | 0.17 | < .001 | |
| Normal NT-proBNP | −0.68 | 0.32 | .04 | .51 |
| Thickness-to-dimension ratio | ||||
| Increased NT-proBNP | −0.80 | 0.18 | < .001 | |
| Normal NT-proBNP | −0.09 | 0.37 | .80 | .09 |
| Fractional shortening | ||||
| Increased hsCRP§ | −0.94 | 0.24 | < .001 | |
| Normal hsCRP | −0.96 | 0.31 | .002 | .95 |
| Mass | ||||
| Increased hsCRP | −0.79 | 0.24 | .001 | |
| Normal hsCRP | −0.88 | 0.18 | < .001 | .77 |
| End-diastolic dimension | ||||
| Increased hsCRP | 0.21 | 0.19 | .28 | |
| Normal hsCRP | −0.31 | 0.21 | .14 | .06 |
| End-systolic dimension | ||||
| Increased hsCRP | 0.61 | 0.20 | .003 | |
| Normal hsCRP | 0.21 | 0.25 | .40 | .21 |
| End-diastolic posterior wall thickness | ||||
| Increased hsCRP | −0.95 | 0.21 | < .001 | |
| Normal hsCRP | −0.75 | 0.21 | < .001 | .50 |
| Thickness-to-dimension ratio | ||||
| Increased hsCRP | −0.92 | 0.21 | < .001 | |
| Normal hsCRP | −0.41 | 0.23 | .08 | .11 |
Abbreviations: cTnT, cardiac troponin T; hsCRP, high-sensitivity C-reactive protein; NT-proBNP, N-terminal pro-brain natriuretic peptide.
*
Increased cTnT defined as > 0.01 ng/mL.
†
Increased NT-proBNP defined as ≥ 100 pg/mL in patients ≥ 1 year old and ≥ 150 pg/mL in patients < 1 year old.
§
Increased hsCRP defined as ≥ 1.9 mg/L.