Çocukluk Çağında Hodgkin Lenfoma Nedeni ile Tedavi Edilmiş Hastalarda Geç Dönem Kardiyotoksisitenin 3 Boyutlu Ekokardiyografi Yöntemi ile Değerlendirilmesi

Abstract

Patients with Hodgkin's Lymphoma (HL) are at risk for long-term development of cardiac disease due to the treatments used. Early detection of cardiac changes in patients allows early intervention. Echocardiography is commonly used method for the evaluation of cardiac functions. 3- dimensional (3D) echocardiography provides a more accurate assessment of the systolic functions of the heart. The aim of this study was to determine the long-term cardiac findings in treated HL patients by 3D echocardiography. We evaluated 50 patients with HL aged 15 years and over in remission for at least two years who had been treated with anthracycline and / or mediastinal radiotherapy in childhood at Hacettepe University. Left ventricular ejection fractions (LVEF) and global strain findings were evaluated by 3D echocardiography. In 10 (20%) patients, LVEF was lower than 53% and no patient had symptoms. Patients with history of mediastinal radiotherapy had significantly lower LVEF, GPSS, and GLS values than those without history of radiotherapy (p = 0.003, p = 0.07, p = 0.018). There was a correlation between LVEF, GPSS and GLS values and radiotherapy dose, but there was no correlation between adriamycin dose and the latter. In our study, the presence of systolic dysfunction was demonstrated in asymptomatic patients who received cardiotoxic therapy. Even shortly after the remission periods, decreased strain findings were detected by 3D echocardiography. In conclusion, routine follow-up of patients with cardiotoxic therapy by sensitive methods is suggested.