Cardiac Mechanical Performance Assessment at Different Levels of Exercise in Childhood Acute Lymphoblastic Leukemia Survivors

Author:

Uwase Egidie1,Caru Maxime12ORCID,Curnier Daniel23,Abasq, Meng Maxence1,Andelfinger Gregor24,Krajinovic Maja24,Laverdière Caroline24,Sinnett Daniel24,Périé Delphine12

Affiliation:

1. Department of Mechanical Engineering, Polytechnique

2. Sainte-Justine University Health Center, Research Center

3. School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC, Canada

4. Department of Pediatrics, University of Montreal

Abstract

Background: There is a shortage of relevant studies interested in cardiac mechanical performance. Thus, it is clinically relevant to study the impact of cancer treatments on survivors’ cardiac mechanical performance to improve our knowledge. The first objective of this study is to assess survivors’ cardiac mechanical performance during a cardiopulmonary exercise test (CPET) using both ventricular-arterial coupling (VAC) and cardiac work efficiency (CWE) from cardiac magnetic resonance (CMR) acquisitions. The second objective is to assess the impact of doxorubicin and dexrazoxane (DEX) treatments. Methods: A total of 63 childhood acute lymphoblastic leukemia survivors underwent a CMR at rest on a 3T magnetic resonance imaging system, followed by a CPET on ergocycle. The CircAdapt model was used to study cardiac mechanical performance. At different levels of exercise, arterial elastance, end-systolic elastance, VAC, and CWE were estimated. Results: We observed significant differences between the different levels of exercise for both VAC (P<0.0001) and CWE parameters (P=0.001). No significant differences were reported between prognostic risk groups at rest and during the CPET. Nevertheless, we observed that survivors in the SR group had a VAC value slightly lower than heart rate (HR)+DEX and HR groups throughout the CPET. Moreover, survivors in the SR group had a CWE parameter slightly higher than HR+DEX and HR groups throughout the CPET. Conclusions: This study reveals that the combination of CPET, CMR acquisitions and CircAdapt model was sensitive enough to observe slight changes in the assessment of VAC and CWE parameters. Our study contributes to improving survivors’ follow-up and detection of cardiac problems induced by doxorubicin-related cardiotoxicity.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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