PDF(Pubmed)
Abstract：
UNASSIGNED: Anthracyclines are associated with cardiac dysfunction. Little is known about the interplay of pre-existing hypertension and treatment response. We aimed to investigate the relationship between hypertension and the development of cancer therapy-related cardiac dysfunction (CTRCD) in pediatric patients treated with anthracycline chemotherapy.
UNASSIGNED: Pediatric patients with cancer who received anthracycline chemotherapy from 2013 to 2021 were retrospectively included. Serial cardiac assessments were conducted during and after chemotherapy. The primary outcome was the development of CTRCD, classified as mild, moderate, or severe according to contemporary definitions.
UNASSIGNED: Among 190 patients undergoing anthracycline chemotherapy, 34 patients (17.9 %) had hypertension (24 patients Stage 1, and 10 patients Stage 2) at baseline evaluation. Patients underwent chemotherapy for a median of 234.4 days (interquartile range 127.8-690.3 days) and were subsequently followed up. Hypertension was frequent during follow-up 31.3 % (0-3 months), 15.8 % (3-6 months), 21.9 % (0.5-1 years), 24.7 % (1-2 years), 31.1 % (2-4 years) and 35.8 % (beyond 4 years) (P for trend < 0.001). Freedom from mild CTRCD at 5 years was 45.0 %, freedom from moderate CTRCD was 87.8 % at 5 years. Baseline hypertension did not increase the risk of mild (HR 0.77, 95 % CI: 0.41-1.42, P = 0.385) or moderate CTRCD (HR 0.62, 95 % CI: 0.14-2.72, P = 0.504). Patients with baseline hypertension showed different global longitudinal strain (P < 0.001) and LVEF (P < 0.001) patterns during follow-up.
UNASSIGNED: Pediatric patients often develop CTRCD post-anthracycline chemotherapy. Those with pre-existing hypertension show a unique treatment response, despite no increased CTRCD risk, warranting further investigation.
UNASSIGNED: Pediatric patients with cancer who received anthracycline chemotherapy from 2013 to 2021 were retrospectively included. Serial cardiac assessments were conducted during and after chemotherapy. The primary outcome was the development of CTRCD, classified as mild, moderate, or severe according to contemporary definitions.
UNASSIGNED: Among 190 patients undergoing anthracycline chemotherapy, 34 patients (17.9 %) had hypertension (24 patients Stage 1, and 10 patients Stage 2) at baseline evaluation. Patients underwent chemotherapy for a median of 234.4 days (interquartile range 127.8-690.3 days) and were subsequently followed up. Hypertension was frequent during follow-up 31.3 % (0-3 months), 15.8 % (3-6 months), 21.9 % (0.5-1 years), 24.7 % (1-2 years), 31.1 % (2-4 years) and 35.8 % (beyond 4 years) (P for trend < 0.001). Freedom from mild CTRCD at 5 years was 45.0 %, freedom from moderate CTRCD was 87.8 % at 5 years. Baseline hypertension did not increase the risk of mild (HR 0.77, 95 % CI: 0.41-1.42, P = 0.385) or moderate CTRCD (HR 0.62, 95 % CI: 0.14-2.72, P = 0.504). Patients with baseline hypertension showed different global longitudinal strain (P < 0.001) and LVEF (P < 0.001) patterns during follow-up.
UNASSIGNED: Pediatric patients often develop CTRCD post-anthracycline chemotherapy. Those with pre-existing hypertension show a unique treatment response, despite no increased CTRCD risk, warranting further investigation.
摘要：
■蒽环类药物与心脏功能障碍有关。关于预先存在的高血压和治疗反应的相互作用知之甚少。我们旨在研究接受蒽环类化疗的儿科患者中高血压与癌症治疗相关的心功能不全（CTRCD）发展之间的关系。
■回顾性纳入2013年至2021年接受蒽环类药物化疗的儿童癌症患者。在化疗期间和之后进行连续的心脏评估。主要结果是CTRCD的发展，归类为轻度，中度,或者根据当代的定义严重。
■在190名接受蒽环类药物化疗的患者中，基线评估时，有34名患者（17.9％）患有高血压（24名患者为1期，10名患者为2期）。患者接受化疗的中位数为234.4天（四分位距127.8-690.3天），随后进行了随访。随访期间高血压发生率为31.3%(0-3个月),15.8%（3-6个月），21.9%（0.5-1年），24.7%（1-2年），31.1％（2-4年）和35.8％（超过4年）（趋势P<0.001）。5年时轻度CTRCD的自由度为45.0％，5年时,中度CTRCD的自由度为87.8%.基线高血压并没有增加轻度（HR0.77，95％CI：0.41-1.42，P=0.385）或中度CTRCD（HR0.62，95％CI：0.14-2.72，P=0.504）的风险。基线高血压患者在随访期间表现出不同的整体纵向应变（P<0.001）和LVEF（P<0.001）模式。
■小儿患者经常在蒽环类药物化疗后发展CTRCD。那些预先存在高血压的人表现出独特的治疗反应，尽管CTRCD风险没有增加，保证进一步调查。
■回顾性纳入2013年至2021年接受蒽环类药物化疗的儿童癌症患者。在化疗期间和之后进行连续的心脏评估。主要结果是CTRCD的发展，归类为轻度，中度,或者根据当代的定义严重。
■在190名接受蒽环类药物化疗的患者中，基线评估时，有34名患者（17.9％）患有高血压（24名患者为1期，10名患者为2期）。患者接受化疗的中位数为234.4天（四分位距127.8-690.3天），随后进行了随访。随访期间高血压发生率为31.3%(0-3个月),15.8%（3-6个月），21.9%（0.5-1年），24.7%（1-2年），31.1％（2-4年）和35.8％（超过4年）（趋势P<0.001）。5年时轻度CTRCD的自由度为45.0％，5年时,中度CTRCD的自由度为87.8%.基线高血压并没有增加轻度（HR0.77，95％CI：0.41-1.42，P=0.385）或中度CTRCD（HR0.62，95％CI：0.14-2.72，P=0.504）的风险。基线高血压患者在随访期间表现出不同的整体纵向应变（P<0.001）和LVEF（P<0.001）模式。
■小儿患者经常在蒽环类药物化疗后发展CTRCD。那些预先存在高血压的人表现出独特的治疗反应，尽管CTRCD风险没有增加，保证进一步调查。
