Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

This study tested the hypothesis that real-time three-dimensional echocardiography may detect subtle Impaired left ventricular myocardial deformation in asymptomatic survivors of childhood cancers after Anthracyclines therapy despite having normal left ventricular shortening fractions.Methods: Thirty Five Anthracyclines-treated survivors of childhood malignancies aged 13.46± 4.44 years and age matched twenty four controls were studied. Three-dimensional echocardiography was performed to assess left ventricular volumes, ejection fraction, sphericity index and 3D global longitudinal, circumferential, radial and area strain.Results: Compared with controls, patients had reduced 3D derived left ventricular ejection fraction (p<0.002), global longitudinal strain (p<0.006), and area strain (p<0.015) (detecting 25%,28.2 and 25% affection of survivors respectively) but not with global circumferential strain .The global 3D longitudinal strain correlated negatively with age at which induction of chemotherapy happened (p<0.001).Conclusions: Three-dimensional speckle tracking was useful for early detection of subtle LV endocardial dysfunction associated with the use of Anthracyclines, and give more evidence about that subendocardial layer of the ventricle is more sensitive to Anthracyclines damage

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