Masood IR; Children’s Hospital of Los Angeles,Los Angeles, USA.
Rezvan PH; Lee K; Vervaet H; Kuo C; Loss K; Menteer J; Souza A;
Freyer D; Su JA

Pediatric Cardiology. 45(7):1493-1502, 2024 Oct.

Cancer survivors exposed to anthracycline chemotherapy are at risk for
developing cardiomyopathy, which may have delayed clinical manifestation.
In a retrospective cross-sectional study, we evaluated the utility of
cardiopulmonary exercise testing (CPET) for detecting early cardiac
disease in 35 pediatric cancer survivors by examining the associations
between peak exercise capacity (measured via percent predicted peak VO2)
and resting left ventricular (LV) function on echocardiography and cardiac
magnetic resonance imaging (cMRI). We additionally assessed the
relationships between LV size on resting echocardiography or cMRI and
percent predicted peak VO2 since LV growth arrest can occur in
anthracycline-exposed patients prior to changes in LV systolic function.
We found reduced exercise capacity in this cohort, with low percent
predicted peak VO2 (62%, IQR: 53-75%). While most patients in our
pediatric cohort had normal LV systolic function, we observed associations
between percent predicted peak VO2 and echocardiographic and cMRI measures
of LV size. These findings indicate that CPET may be more sensitive in
manifesting early anthracycline-induced cardiomyopathy than
echocardiography in pediatric cancer survivors. Our study also highlights
the importance of assessing LV size in addition to function in pediatric
cancer survivors exposed to anthracyclines.