WIP 48 - Using Wall Thickness as a Predictor for Cardiac Function in Pediatric Cancer Survivors Exposed to Anthracyclines

Publication Number: WIP 48.7638

Ashley Rodgers, The Children's Hospital at Montefiore, Tuckahoe, NY, United States; Elena N. Kwon, The Children's Hospital at Montefiore, Port Washington, NY, United States; Daphne T. Hsu, Albert Einstein College of Medicine, Bronx, NY, United States; Moriah Rabin, The Children's Hospital at Montefiore, Bronx, NY, United States

Background: Despite improvement in pediatric cancer survival rates, long term effects of chemotherapy contribute to morbidity and mortality. Anthracyclines (AT) are known to increase risk of cardiomyopathy, but our understanding of who develops heart failure and how quickly it occurs is still unclear. Ejection fraction (EF) is used to monitor survivors, however, decreases in EF occur once the patient has already developed disease. Previous studies have assessed wall thickness (WT) as an early marker of cardiac dysfunction, yet its predictive value has not been consistent.

Objective: We aim to examine the effects of AT treatment on left ventricular (LV) WT as an early marker of cardiac dysfunction in pediatric cancer survivors. We will evaluate WT throughout post-chemotherapy treatment screening echocardiograms to assess for changes over time.

Design/Methods: This is an IRB-approved retrospective chart review study that evaluates the cohort of pediatric cancer survivors at our children's hospital, a pediatric tertiary care center. 242 patients were identified, with 92 meeting inclusion criteria and 32 patients with data collection completed thus far. Exploratory comparisons of LV WT Z-scores and mass/volume ratios will be performed to assess for change over time from pre- and post-chemotherapy echocardiograms. Demographics and details of cancer treatment will be collected. Clinic and hospital notes will be utilized to identify cardiac symptoms and interventions at the time of each echocardiogram. Paired t-tests will compare LV WT Z-scores and mass/volume ratios for patients who received low dose AT with those who received high dose AT. Our goal is to complete data collection by January 2025 and analysis by February 2025. We expect the LV wall to become thinner over time prior to dilatation of the LV. Therefore, we expect to see decreases in mass/volume ratios over time. We hypothesize a 25% decrease in LV WT Z-scores 2-5 years before a change in EF is seen and that decreases in WT will occur more often in those treated with high dose versus low dose AT.