The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study Artan kümülatif antrasiklin dozunun kanserli çocuklardaki kardiyak repolarizasyon değişiklikleri üzerine etkileri: prospektif bir çalışma
Pamukkale Medical Journal, cilt.14, sa.2, ss.362-370, 2021 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 2
- Basım Tarihi: 2021
- Doi Numarası: 10.31362/patd.815376
- Dergi Adı: Pamukkale Medical Journal
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.362-370
- Anahtar Kelimeler: anthracyclines, cardiac toxicity, Childhood cancer, dispersion, ECG
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: We aimed to prospectively interpret the cardiac repolarization changes with 12-lead electrocardiography (ECG) in children with cancer who were treated with anthracycline drugs. Materials and methods: A total of 53 patients with cancer treated with anthracycline were enrolled in the study. During 6-month follow-up, standard 12-lead ECG was performed at basal, 1st, 4th, and 24th hours after the first dose of anthracycline treatment, at the time of 120 mg/m2 cumulative anthracycline dose and 240 mg/m2 of cumulative anthracycline dose in the same patients, respectively. P dispersion (PWd), QT dispersion (QTd), corrected QT dispersion (QTcd), Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were obtained from 12-lead ECG. The patients were classified into three groups according to increasing cumulative anthracycline doses: Group 1: first dose (n=53), Group 2: 120 mg/m2 (n=53), Group 3: 240 mg/m2 (n=53). Results: The median age was 48 months (range 9-192 months). While PWd, QTd, QTcd, and Tp-e interval were significantly increased during first 24 hours of the first dose (p<0.001, p=0.005, p=0.041, p=0.016, respectively), Tp-e/QT and Tp-e/QTc ratios were significantly altered during first 24 hours of 120 mg/m2 cumulative dose of anthracycline treatment (p<0.001). Any changes in 12-lead ECG were not significantly at 240 mg/m2 cumulative dose. However, it was detected that all variables were affected according to each increased anthracycline cumulative dose despite it was not statistically significant. Conclusions: ECG parameters such as PWd, QTd, QTcd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios are useful for detecting subclinical cardiac abnormality and acute anthracycline toxicity during both uses of single-dose anthracycline and increased anthracycline doses. These parameters may also predict arrhythmias in patients with cancer.