TY - JOUR
T1 - Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility
AU - Merkx, Remy
AU - Leerink, Jan M.
AU - Feijen, Elisabeth (Lieke) A. M.
AU - Kremer, Leontien C. M.
AU - de Baat, Esmée C.
AU - Bellersen, Louise
AU - van Dalen, Elvira C.
AU - van Dulmen-den Broeder, Eline
AU - van der Heiden-van der Loo, Margriet
AU - van den Heuvel-Eibrink, Marry M.
AU - Korte, Chris L. de
AU - Loonen, Jacqueline
AU - Louwerens, Marloes
AU - Maas, Angela H. E. M.
AU - Pinto, Yigal M.
AU - Ronckers, C. cile M.
AU - Teske, Arco J.
AU - Tissing, Wim J. E.
AU - de Vries, Andrica C. H.
AU - Mavinkurve-Groothuis, Annelies M. C.
AU - van der Pal, Helena J. H.
AU - Weijers, Gert
AU - Kok, Wouter E. M.
AU - Kapusta, Livia
AU - the Dutch LATER Study group
AU - Versluys, Birgitta
AU - Grootenhuis, Martha
AU - van Leeuwen, Flora
AU - Neggers, Sebastian
AU - van der Steeg, Lideke
AU - Janssens, Geert
AU - van Santen, Hanneke
AU - Veening, Margreet
AU - den Hartogh, Jaap
AU - Pluijm, Saskia
AU - Batenburg, Lilian
AU - de Ridder, Hanneke
AU - Hollema, Nynke
AU - Teunissen, Lennart
AU - Schellekens, Anke
N1 - Funding Information: Dutch Heart Foundation Grant CVON2015‐21; Kika/ODAS Grant 171 ‘DCOG LATER program’. Funding Information: Dutch Heart Foundation Grant CVON2015-21; Kika/ODAS Grant 171 ?DCOG LATER program?. We thank the other members of the DCOG LATER consortium (Birgitta Versluys, Martha Grootenhuis, Flora van Leeuwen, Sebastian Neggers, Lideke van der Steeg, Geert Janssens, Hanneke van Santen, Margreet Veening, Jaap den Hartogh, Saskia Pluijm, Lilian Batenburg, Hanneke de Ridder, Nynke Hollema, Lennart Teunissen, Anke Schellekens) and all physicians, research nurses, data managers and participating patients, parents and siblings for their contribution. Publisher Copyright: © 2021 The Authors. Echocardiography published by Wiley Periodicals LLC Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - 2D echocardiography
KW - cardiac toxicity
KW - diastolic function
KW - myocardial strain
KW - systolic function
UR - http://www.scopus.com/inward/record.url?scp=85106253199&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/echo.15081
DO - https://doi.org/10.1111/echo.15081
M3 - Article
C2 - 34013999
SN - 0742-2822
VL - 38
SP - 951
EP - 963
JO - Echocardiography (Mount Kisco, N.Y.)
JF - Echocardiography (Mount Kisco, N.Y.)
IS - 6
ER -