TY - JOUR
T1 - Electrocardiographic abnormalities in childhood cancer survivors treated with cardiotoxic therapy
T2 - a systematic review
AU - de Baat, Esmée C.
AU - Feijen, Elizabeth A. M.
AU - van Niekerk, Jorrit B.
AU - Mavinkurve-Groothuis, Annelies M. C.
AU - Kapusta, Livia
AU - Loonen, Jacqueline
AU - Kok, Wouter E. M.
AU - Kremer, Leontien C. M.
AU - van Dalen, Elvira C.
AU - van der Pal, Helena J. H.
N1 - Funding Information: This study was supported by Dutch Heart Foundation grant CVON2015‐21. Funding Information: informationThis study was supported by Dutch Heart Foundation grant CVON2015-21.We thank the library of Amsterdam University Medical Center location Amsterdam Medical Center; Amsterdam, The Netherlands. We also thank F. Etten for checking and helping with finalizing the systematic search for MEDLINE and Embase. Publisher Copyright: © 2022 Wiley Periodicals LLC.
PY - 2022/8
Y1 - 2022/8
N2 - Purpose: The purpose of this study is to assess the available literature on the prevalence and risk factors of electrocardiographic (ECG) abnormalities after cardiotoxic treatment in childhood cancer survivors (CCS). Methods: A literature search was performed within MEDLINE, EMBASE, and CENTRAL (1966-11/2020) and reference lists of relevant studies. Studies were eligible for inclusion if they reported ECG abnormalities ≥2 years after cancer diagnosis in ≥50 CCS treated with anthracyclines, RT involving the heart region and/or mitoxantrone. Information about population, treatment, outcome, and risk factors were extracted and risk of bias was assessed. Results: Of 934 identified publications, 10 studies were included. Outcome definitions, treatment regimens, follow-up period, and risk of bias varied. These ECG abnormalities and prevalences were reported: major (5%-23%) and minor (12%) abnormalities according to the Minnesota Code, rhythm abnormalities (0%-12%), conduction abnormalities (0.3%-7.1%), depolarization abnormalities (0%), and repolarization abnormalities (0%-65%). The reported risk factors of ECG abnormalities (two studies) are male sex, anthracyclines, RT involving the heart region, and hypertension, although results were not univocal between studies and abnormalities. Conclusions: Multiple ECG abnormalities have been described in CCS ≥2 years from diagnosis, some of which can have important implications. Future research is needed to evaluate the exact long-term incidence and risk factors, and to investigate their clinical relevance and relation with cardiac dysfunction or future cardiac events. This could improve cardiac surveillance for CCS.
AB - Purpose: The purpose of this study is to assess the available literature on the prevalence and risk factors of electrocardiographic (ECG) abnormalities after cardiotoxic treatment in childhood cancer survivors (CCS). Methods: A literature search was performed within MEDLINE, EMBASE, and CENTRAL (1966-11/2020) and reference lists of relevant studies. Studies were eligible for inclusion if they reported ECG abnormalities ≥2 years after cancer diagnosis in ≥50 CCS treated with anthracyclines, RT involving the heart region and/or mitoxantrone. Information about population, treatment, outcome, and risk factors were extracted and risk of bias was assessed. Results: Of 934 identified publications, 10 studies were included. Outcome definitions, treatment regimens, follow-up period, and risk of bias varied. These ECG abnormalities and prevalences were reported: major (5%-23%) and minor (12%) abnormalities according to the Minnesota Code, rhythm abnormalities (0%-12%), conduction abnormalities (0.3%-7.1%), depolarization abnormalities (0%), and repolarization abnormalities (0%-65%). The reported risk factors of ECG abnormalities (two studies) are male sex, anthracyclines, RT involving the heart region, and hypertension, although results were not univocal between studies and abnormalities. Conclusions: Multiple ECG abnormalities have been described in CCS ≥2 years from diagnosis, some of which can have important implications. Future research is needed to evaluate the exact long-term incidence and risk factors, and to investigate their clinical relevance and relation with cardiac dysfunction or future cardiac events. This could improve cardiac surveillance for CCS.
KW - cancer survivors
KW - cardiotoxicity
KW - children
KW - electrocardiography
UR - http://www.scopus.com/inward/record.url?scp=85129022475&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pbc.29720
DO - https://doi.org/10.1002/pbc.29720
M3 - Review article
C2 - 35482534
SN - 1545-5009
VL - 69
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 8
M1 - e29720
ER -