Cardiac function in XXXX survivors.

@entity1 @entity632 @entity8253 @entity4349 @entity4346 @entity299 @entity3969 @entity1370
PURPOSE: To study late cardiac function in a single diagnostic group ( @entity1 with @entity3969 ) with good long-term survival; to compare @entity1 treated with @entity8253 ( @entity632 ) with @entity1 treated without @entity8253 and with a normal @entity1 /adolescent group; and to examine the risk factors involved in late @entity299 . @entity1 AND METHODS: Echocardiographic studies were performed on 97 @entity3969 @entity1 treated with @entity8253 (mean cumulative dose, 303 mg/m2) with a mean follow-up time of 7.1 years, on 39 @entity3969 @entity1 treated without @entity8253 with a mean follow-up time of 8.9 years, and on 50 normal subjects. Left ventricular (LV) dimensions, end systolic wall stress (a measure of afterload), and load-dependent and -independent measures of contractility were compared between groups. Potential risk factors, including age at diagnosis, follow-up duration, sex, pubertal status, cardiac irradiation, dose-intensity, and cumulative dose of @entity8253 , were studied by multivariate analysis. RESULTS: Twenty-five percent of the @entity4349 -treated group showed @entity299 . All but one of these @entity1 had increased LV afterload. Risk factors for increased afterload were @entity4349 cumulative dose (P < .05) and @entity4349 dose-intensity (P < .02). @entity3969 @entity1 treated without @entity8253 had thickened LV walls compared with normal subjects (P < .05). CONCLUSION: Total dose and dose-intensity of @entity4349 were risk factors for increased LV afterload in long-term @entity3969 survivors treated on standard protocols. The increase in afterload accounted for reduced LV shortening, whereas contractility was rarely abnormal. The new finding that @entity3969 survivors who do not receive @entity8253 have mild @entity4346 may provide some protection against @entity4349 -induced @entity1370 effects.
