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Pediatric Transplants

Changes in echocardiographic measures of systolic and diastolic function in children 1 year after hematopoietic SCT

Bone Marrow Transplantation volume 46, pages 1532–1539 (2011)Cite this article

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Abstract

Hematopoietic SCT (HSCT) is a life-saving therapy in children, but has been associated with heart failure. Little is known about subclinical changes in cardiac function. We examined changes in systolic and diastolic function from pre- to 1-year post HSCT by echocardiography. All patients (n=74, 61% men, median age 9.1 years, mean left-ventricular (LV) ejection fraction 61.3±4.9%) who underwent HSCT at Children's Hospital Boston between 2005 and 2008, were <21 years at time of HSCT, and had routine pre- and 1-year post echocardiograms were included. Systolic function parameters, including LV ejection fraction, rate-corrected velocity of fiber shortening (Vcfc) and stress-velocity index and diastolic parameters, including tissue Doppler imaging (TDI)-derived velocities, and left-ventricular flow propagation, were compared before and after transplant. At 1-year post HSCT, systolic function, as measured by Vcfc (1.10±0.15 vs 1.04±0.12 circ/s; P=0.03) and stress-velocity index (z-score 0.40±1.4 vs −0.20±1.1; P=0.02), had worsened; diastolic function parameters, including mitral E′ velocity (16.6±3.9 vs 15.0±3.4 cm/s; P=0.01) and tricuspid E′ velocity (14.3±3.6 vs 12.4±2.8 cm/s; P=0.002) had also decreased. At 1-year post HSCT, children have subclinical declines in systolic and diastolic function. These small changes might become clinically important over time. Serial non-invasive assessment of cardiac function should be considered in all children following HSCT.

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Acknowledgements

Acknowledgment of research support: Dr Daly received salary support from a NIH training grant (T32 HL07572) while working on this study. Dr Chen is supported by the Children's Hospital Boston Department of Cardiology Translational Fund for Research in Cardiac Oncology. Dr Blume is supported by the Children's Hospital Boston Department of Cardiology Heart Failure/Transplant Research Fund. Previously presented: Young Investigator Oral Abstract Presentation, 2nd International Conference on Cardiomyopathy in Children, 13 May, 2010 in Bethesda, MD, USA.

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Authors and Affiliations

  1. Department of Cardiology, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA

    K P Daly, S D Colan, E D Blume, R Margossian, K Gauvreau & M H Chen

  2. Division of Hematology/Oncology, Department of Medicine, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA

    C Duncan & L E Lehmann

  3. Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA

    C Duncan & L E Lehmann

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  1. K P Daly
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Daly, K., Colan, S., Blume, E. et al. Changes in echocardiographic measures of systolic and diastolic function in children 1 year after hematopoietic SCT. Bone Marrow Transplant 46, 1532–1539 (2011). https://doi.org/10.1038/bmt.2010.345

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