Navegando por Palavras-chave "Global Longitudinal Two-Dimensional Strain"

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    A Produção Acadêmica Sobre As Relações Étnico-Raciais Em Livro Didático (2005 - 2015)
    (Universidade Federal de São Paulo (UNIFESP), 2017-03-29) Santos, Maria Veronica Camara Dos [UNIFESP]; Moises, Valdir Ambrosio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Anthracyclines are effective drugs for cancer treatment, but are strongly associated with early or late cardiotoxicity. Left ventricular ejection fraction (LVEF) by echocardiography is recommended for the diagnosis. Left ventricular global longitudinal two-dimensional strain (LVGL2DS) by speckle tracking echocardiography (STE) seems to have high sensitivity. The aim of this study was to analyze the global and segmental LV systolic function and LVGL2DS by STE in patients late after treatment of osteosarcoma. Methods: Survivors of osteosarcoma, treated during adolescence with doxorubicin and epirubicin, according with the protocol at the time of treatment, and a group of healthy controls, participated in this study with clinical and conventional echocardiographic evaluations including LVGL2DS by STE. Subgroup 1, patients had normal LVEF ( 53%), and subgroup 2, abnormal LVEF (< 53%). LVGL2DS was normal if ≤ -18.9 %. Data were analyzed and compared with parametric or nonparametric tests as appropriated; significant if p < 0.05. Results: 26 patients (26.2 years; 13 females) and 13 controls were included in the study. The meantime since treatment was 9.9 ± 2.9 years and doxorubicin cumulative dose was 347 ± 39.6 mg/m². Only one patient included in the study (3.85%) received epirubicin (Study III), and had his cumulative dose converted for doxorubicin model as recommended by the Children’s Oncology Group Guidelines. Twenty patients were in subgroup 1, and 6 in subgroup 2. LVGL2DS was lower in subgroups 1 (-17.6 ± 2.8%) and 2 (-14.5  3.9%) compared to control (-20.4  1.9%) (< 0.01). For all patients, the proportion of cardiotoxicity increased from 6/26 (23%), with LVEF only, to 17/26 (65%) when adding LVGL2DS analysis. The basal segments of septal, anteroseptal and inferior walls were more frequently altered with higher strain values (less negatives, mathematically) than other segments of the same walls. Conclusions: Late after treatment of osteosarcoma, patients had decreased LVGL2DS despite normal LVEF that possibly represents hidden cardiotoxicity. Basal myocardial segments were more affected.