Table 1.
Studies with cardiac outcomes
| Author | Country | N | Sex (% male) | Diagnosesa | Age (Dx) | Age (follow-up) | Follow-up time | Treatment modality | Outcome assessments | Prevalence/result | Risk factors | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chemo | Rad | HCST | |||||||||||
| Hamada [80] | Japan | 26 | 73% | Mixed | NR |
13.5 [6–22] |
5.6 [1.2–10.7] post-tx |
✓ (NR) |
NR | NR | Dobutamine stress ECG |
• Group who received higher dose of anthracyclines had lower cardiac function at rest than other groups with lower doses. • Subclinical cardiotoxicity found even in groups with ≥ 200 mg/m2 |
• Anthracycline cumulative dose ≥ 200 mg/m2 |
| Cheung [79] | HK | 36 | 54% | Leukemia | NR | 15.6 ± 5.5 |
7.0 [3.1–24.3] post-tx |
✓ (100%) |
NR | NR | Left ventricular twisting and untwisting motion | • Impairment of LV twisting NR and untwisting motion evident even in those with normal LV ejection | |
| Shimomura [78] | Japan | 61 | 49% | Leukemia | 5.7 ± 3.5 |
14.7 ± 3.5 [7.6–25.7] |
8.1 [1.7–12.5] post-tx |
✓ (100%) |
✓ (NR) |
NR | ECG, echocardiogram, serum BNP |
• Ventricular premature contraction (3.3%) • Reduced exercise tolerance (12.2%) • Abnormal BNP levels (10%) |
• Pirarubicin dose ≥ 300 mg/m2 |
| Cheung [77] | HK | 100 | 57% | Leukemia |
8.0 [3–13] |
24.1 ± 4.2 |
15.3 ± 5.8 post-tx |
✓ (100%) |
✓ (13%) |
✓ (15%) |
Plasma high sensitivity troponin T, conventional, 3D and speckle tracking echocardiogram |
• Elevated troponin T (19%) • Worse LV myocardial deformation in survivors than controls |
• Cumulative anthracycline dose • Cardiac radiation • Leukemic relapse • Stem cell transplant • CYBA rs4673 polymorphism |
| Yu [76] | HK | 32 | 66% | Mixed | NR | 19.3 ± 5.4 |
6.9 [2.2–14.4] post-tx |
✓ (100%) |
NR | NR | 3D and 2D speckle tracking echocardiogram | • Impairment of subendocardial circumferential deformation and apical rotation in survivors than controls. | • Cumulative anthracyclines dose |
| Yu [75] | HK | 53 | 70% | Mixed | NR | 18.6 ± 5.1 |
7.2 [2.4–16.4] post-tx |
✓ (100%) |
NR | NR | 3D speckle tracking echocardiogram | • Lower LV global 3D strain, twist and torsion, and LV regional deformation in survivors than controls | • Cumulative anthracyclines dose |
| Cheung [74] | HK | 58 | 57% | Leukemia | 7.6 ± 4.7 | 24.5 ± 4.4 |
16.6 ± 5.8 post-tx |
✓ (100%) |
✓ (14%) |
✓ (14%) |
Cardiac MRI, Tissue Doppler Imaging |
• Subnormal LV ejection fraction (9%) • Abnormal and subnormal RV ejection fraction in 12% and 34%, respectively • LV fibrosis (9%) • RV fibrosis (38%) |
• Cumulative anthracyclines dose |
| Li [73] | HK | 94 | 56% | Leukemia | 12.9 ± 6.8 | 22.2 ± 5.5 | 14.9 ± 6.2 |
✓ (100%) |
✓ (12%) |
✓ (12%) |
Calibrated integrated backscatter, M-mode, Doppler and speckle tracking echocardiography | • Lower LV diastolic wall strain and stiffer LV myocardium in survivors than controls | • Older age at follow-up |
| Li [72] | HK | 49 | 53% | Mixed | 8.1 ± 4.5 | 22.9 ± 5.8 |
14.2 ± 5.4 post-tx |
✓ (100%) |
✓ (2%) |
✓ (2%) |
Calibrated integrated backscatter, M-mode, Doppler and speckle tracking echocardiography, plasma proANP | • Left atrial remodeling as characterized by contractile dysfunction and increased fibrosis in survivors than controls. | NR |
aBreakdown of cancer diagnoses are presented in Table 1
Studies are arranged in chronological order
BNP brain natriuretic peptide, Dx diagnosis, ECG electrocardiography, HK Hong Kong, LV left ventricular, MRI magnetic resonance imaging, NR not reported, proANP pro-atrial natriuretic peptide, RV right ventricular, tx treatment