Impaired exercise capacity and left ventricular function in long-term adult survivors of childhood XXXX .

@entity981 @entity8253 @entity4349 @entity5 @entity26 @entity1370 @entity1002
BACKGROUND: Survivors of childhood @entity981 ( @entity981 ) are at risk for late @entity1370 effects of @entity5 treatment, but conflicting evidence exists on the effects of @entity8253 on left ventricular (LV) diastolic function and exercise capacity. PROCEDURE: We performed a cross-sectional study with comprehensive echocardiography in 138 adult survivors of childhood @entity981 , median 23.4 years after diagnosis. Pulsed tissue Doppler measurements of early diastolic mitral annular velocities (e') were used for the assessment of diastolic function, and compared to 138 matched controls. Of the survivors, 133 also performed ergospirometry measuring peak @entity26 uptake (VO2 max). Associations between @entity5 treatment, LV function, and VO2 max were analyzed. RESULTS: The survivor group had lower e' values than controls (e' septal 11.0 vs. 12.6   cm/s, P   <   0.001), but the difference was confined to the subgroup of @entity4349 treated survivors (median cumulative dose 120   mg/m(2) ). @entity4349 exposure was inversely correlated with e' (regression coefficient -1.581, P   =   0.009). Reduced VO2 max/kg occurred in 47% of the survivors, but more often in @entity4349 treated survivors (56%) than @entity4349 na  ve survivors (17%, P   <   0.001). @entity4349 exposure was inversely correlated with VO2 max/kg (regression coefficient -3.084, P   =   0.05 in multivariate analysis). Furthermore, associations were observed between measures of LV function and VO2 max/kg, and e' was the best predictor of VO2 max/kg (standardized coefficient 0.355, P   <   0.001 in multivariate analysis). CONCLUSIONS: Adult survivors of childhood @entity981 have increased risk for @entity1002 and impaired exercise capacity, both associated with previous @entity4349 exposure. Furthermore, there is an association between LV diastolic function and exercise capacity. Pediatr @entity5    2015 Wiley Periodicals, Inc.
