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Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility
BACKGROUND: Cardiotoxicity is a well‐known side effect after anthracyclines and chest radiotherapy in childhood cancer survivors (CCS). The DCCSS LATER 2 CARD (cardiology) study includes evaluation of echocardiographic measurements for early identification of CCS at highest risk of developing heart...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251836/ https://www.ncbi.nlm.nih.gov/pubmed/34013999 http://dx.doi.org/10.1111/echo.15081 |
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author | Merkx, Remy Leerink, Jan M. Feijen, Elisabeth (Lieke) A.M. Kremer, Leontien C.M. de Baat, Esmée C. Bellersen, Louise van Dalen, Elvira C. van Dulmen‐den Broeder, Eline van der Heiden‐van der Loo, Margriet van den Heuvel‐Eibrink, Marry M. de Korte, Chris L. Loonen, Jacqueline Louwerens, Marloes Maas, Angela H.E.M. Pinto, Yigal M. Ronckers, Cécile M. Teske, Arco J. Tissing, Wim J.E. de Vries, Andrica C.H. Mavinkurve‐Groothuis, Annelies M.C. van der Pal, Helena J.H. Weijers, Gert Kok, Wouter E.M. Kapusta, Livia |
author_facet | Merkx, Remy Leerink, Jan M. Feijen, Elisabeth (Lieke) A.M. Kremer, Leontien C.M. de Baat, Esmée C. Bellersen, Louise van Dalen, Elvira C. van Dulmen‐den Broeder, Eline van der Heiden‐van der Loo, Margriet van den Heuvel‐Eibrink, Marry M. de Korte, Chris L. Loonen, Jacqueline Louwerens, Marloes Maas, Angela H.E.M. Pinto, Yigal M. Ronckers, Cécile M. Teske, Arco J. Tissing, Wim J.E. de Vries, Andrica C.H. Mavinkurve‐Groothuis, Annelies M.C. van der Pal, Helena J.H. Weijers, Gert Kok, Wouter E.M. Kapusta, Livia |
author_sort | Merkx, Remy |
collection | PubMed |
description | BACKGROUND: Cardiotoxicity is a well‐known side effect after anthracyclines and chest radiotherapy in childhood cancer survivors (CCS). The DCCSS LATER 2 CARD (cardiology) study includes evaluation of echocardiographic measurements for early identification of CCS at highest risk of developing heart failure. This paper describes the design, feasibility, and reproducibility of the echocardiography protocol. METHODS: Echocardiograms from CCS and sibling controls were prospectively obtained at the participating centers and centrally analyzed. We describe the image acquisition, measurement protocol, and software‐specific considerations for myocardial strain analyses. We report the feasibility of the primary outcomes of systolic and diastolic function, as well as reproducibility analyses in 30 subjects. RESULTS: We obtained 1,679 echocardiograms. Biplane ejection fraction (LVEF) measurement was feasible in 91% and 96% of CCS and siblings, respectively, global longitudinal strain (GLS) in 80% and 91%, global circumferential strain (GCS) in 86% and 89%, and ≥2 diastolic function parameters in 99% and 100%, right ventricle free wall strain (RVFWS) in 57% and 65%, and left atrial reservoir strain (LASr) in 72% and 79%. Intra‐class correlation coefficients for inter‐observer variability were 0.85 for LVEF, 0.76 for GLS, 0.70 for GCS, 0.89 for RVFWS and 0.89 for LASr. Intra‐class correlation coefficients for intra‐observer variability were 0.87 for LVEF, 0.82 for GLS, 0.82 for GCS, 0.85 for RVFWS and 0.79 for LASr. CONCLUSION: The DCCSS LATER 2 CARD study includes a protocolized echocardiogram, with feasible and reproducible primary outcome measurements. This ensures high‐quality outcome data for prevalence estimates and for reliable comparison of cardiac function parameters. |
format | Online Article Text |
id | pubmed-8251836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82518362021-07-07 Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility Merkx, Remy Leerink, Jan M. Feijen, Elisabeth (Lieke) A.M. Kremer, Leontien C.M. de Baat, Esmée C. Bellersen, Louise van Dalen, Elvira C. van Dulmen‐den Broeder, Eline van der Heiden‐van der Loo, Margriet van den Heuvel‐Eibrink, Marry M. de Korte, Chris L. Loonen, Jacqueline Louwerens, Marloes Maas, Angela H.E.M. Pinto, Yigal M. Ronckers, Cécile M. Teske, Arco J. Tissing, Wim J.E. de Vries, Andrica C.H. Mavinkurve‐Groothuis, Annelies M.C. van der Pal, Helena J.H. Weijers, Gert Kok, Wouter E.M. Kapusta, Livia Echocardiography Original Investigations BACKGROUND: Cardiotoxicity is a well‐known side effect after anthracyclines and chest radiotherapy in childhood cancer survivors (CCS). The DCCSS LATER 2 CARD (cardiology) study includes evaluation of echocardiographic measurements for early identification of CCS at highest risk of developing heart failure. This paper describes the design, feasibility, and reproducibility of the echocardiography protocol. METHODS: Echocardiograms from CCS and sibling controls were prospectively obtained at the participating centers and centrally analyzed. We describe the image acquisition, measurement protocol, and software‐specific considerations for myocardial strain analyses. We report the feasibility of the primary outcomes of systolic and diastolic function, as well as reproducibility analyses in 30 subjects. RESULTS: We obtained 1,679 echocardiograms. Biplane ejection fraction (LVEF) measurement was feasible in 91% and 96% of CCS and siblings, respectively, global longitudinal strain (GLS) in 80% and 91%, global circumferential strain (GCS) in 86% and 89%, and ≥2 diastolic function parameters in 99% and 100%, right ventricle free wall strain (RVFWS) in 57% and 65%, and left atrial reservoir strain (LASr) in 72% and 79%. Intra‐class correlation coefficients for inter‐observer variability were 0.85 for LVEF, 0.76 for GLS, 0.70 for GCS, 0.89 for RVFWS and 0.89 for LASr. Intra‐class correlation coefficients for intra‐observer variability were 0.87 for LVEF, 0.82 for GLS, 0.82 for GCS, 0.85 for RVFWS and 0.79 for LASr. CONCLUSION: The DCCSS LATER 2 CARD study includes a protocolized echocardiogram, with feasible and reproducible primary outcome measurements. This ensures high‐quality outcome data for prevalence estimates and for reliable comparison of cardiac function parameters. John Wiley and Sons Inc. 2021-05-20 2021-06 /pmc/articles/PMC8251836/ /pubmed/34013999 http://dx.doi.org/10.1111/echo.15081 Text en © 2021 The Authors. Echocardiography published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Investigations Merkx, Remy Leerink, Jan M. Feijen, Elisabeth (Lieke) A.M. Kremer, Leontien C.M. de Baat, Esmée C. Bellersen, Louise van Dalen, Elvira C. van Dulmen‐den Broeder, Eline van der Heiden‐van der Loo, Margriet van den Heuvel‐Eibrink, Marry M. de Korte, Chris L. Loonen, Jacqueline Louwerens, Marloes Maas, Angela H.E.M. Pinto, Yigal M. Ronckers, Cécile M. Teske, Arco J. Tissing, Wim J.E. de Vries, Andrica C.H. Mavinkurve‐Groothuis, Annelies M.C. van der Pal, Helena J.H. Weijers, Gert Kok, Wouter E.M. Kapusta, Livia Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title | Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title_full | Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title_fullStr | Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title_full_unstemmed | Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title_short | Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility |
title_sort | echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter dccss later 2 card study: design, feasibility, and reproducibility |
topic | Original Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251836/ https://www.ncbi.nlm.nih.gov/pubmed/34013999 http://dx.doi.org/10.1111/echo.15081 |
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