The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study

Yıl: 2021 Cilt: 14 Sayı: 2 Sayfa Aralığı: 362 - 370 Metin Dili: İngilizce DOI: 10.31362/patd.815376 İndeks Tarihi: 17-06-2021

The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study

Öz:
Purpose: We aimed to prospectively interpret the cardiac repolarization changes with 12-lead electrocardiography(ECG) in children with cancer who were treated with anthracycline drugs.Materials and methods: A total of 53 patients with cancer treated with anthracycline were enrolled in the study.During 6-month follow-up, standard 12-lead ECG was performed at basal, 1st, 4th, and 24th hours after thefirst dose of anthracycline treatment, at the time of 120 mg/m2 cumulative anthracycline dose and 240 mg/m2of cumulative anthracycline dose in the same patients, respectively. P dispersion (PWd), QT dispersion (QTd),corrected QT dispersion (QTcd), Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were obtained from 12-lead ECG.The patients were classified into three groups according to increasing cumulative anthracycline doses: Group 1:first dose (n=53), Group 2: 120 mg/m2 (n=53), Group 3: 240 mg/m2 (n=53).Results: The median age was 48 months (range 9-192 months). While PWd, QTd, QTcd, and Tp-e interval weresignificantly increased during first 24 hours of the first dose (p<0.001, p=0.005, p=0.041, p=0.016, respectively),Tp-e/QT and Tp-e/QTc ratios were significantly altered during first 24 hours of 120 mg/m2 cumulative dose ofanthracycline treatment (p<0.001). Any changes in 12-lead ECG were not significantly at 240 mg/m2 cumulativedose. However, it was detected that all variables were affected according to each increased anthracyclinecumulative dose despite it was not statistically significant.Conclusions: ECG parameters such as PWd, QTd, QTcd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios areuseful for detecting subclinical cardiac abnormality and acute anthracycline toxicity during both uses of singledose anthracycline and increased anthracycline doses. These parameters may also predict arrhythmias inpatients with cancer.
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Öz:
Amaç: Antrasiklin kemoterapisi ile tedavi edilen kanserli çocuklarda kardiyak repolarizasyon değişikliklerini 12 derivasyonlu elektrokardiyografi (EKG) ile değerlendirmeyi amaçladık. Gereç ve yöntem: Antrasiklin ile tedavi edilen kanserli toplam 53 hasta çalışmaya dahil edildi. Bu hastalara 12 derivasyonlu EKG ile antrasiklin tedavisinin ilk dozu, 120 mg/m2ve 240 mg/m2kümülatif dozu sırasında her doz uygulamasının ilaç verilmeden hemen öncesinde ve ilaç verildikten sonraki 1., 4. ve 24. saatinde EKG’leri çekildi. Bu EKG’lerden P dispersiyonu (PWd), QT dispersiyonu (QTd), düzeltilmiş QT dispersiyonu (QTcd), Tp-e aralığı, Tp-e/QT ve Tp-e/QTc oranı hesaplandı. Hastalar artan kümülatif antrasiklin dozlarına göre üç gruba ayrıldı: Grup 1: ilk doz (n=53), Grup 2: 120 mg/m2(n=53), Grup 3: 240 mg/m2(n=53). Bulgular: Ortanca yaş 48 ay (aralık 9-192 ay) idi. İlk dozun ilk 24 saatinde PWd, QTd, QTcd ve Tp-e değişkenleri anlamlı olarak artış gösterdiği saptandı. (sırasıyla p<0,001, p=0,005, p=0,041, p=0,016). 120 mg/m2kümülatif antrasiklin tedavisinin ilk 24 saatinde ise Tp-e/QT and Tp-e/QTc oranları istatistiksel anlamlı olarak değişiklik gösterdi (p<0,001). 240 mg/m2kümülatif antrasiklin dozunda ise herhangi bir anlamlı değişiklik saptanmadı. Ancak istatistiksel olarak anlamlı olmamakla birlikte, artan her antrasiklin kümülatif doza bağlı olarak disperisyon değişkenlerinde uzama, Tp-e/QT ve Tp-e/QTc oranlarında ise azalma olduğu belirlendi. Sonuç: PWd, QTd, QTcd, Tp-e aralığı, Tp-e/QT ve Tp-e/QTc oranları gibi EKG değişkenleri, hem tek doz antrasiklin hem de artan antrasiklin kullanımı sırasında subklinik kardiyak toksisite ve akut antrasiklin toksisitesinin bulgularını saptamada yararlı olduğunu gösterdi. Bu parametreler değerlendirildiğinde kanserli hastalarda aritmileri de belirlemede önemli olacaktır.
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APA Aydın S, Oymak Y, Meşe T, yılmazer m, Demirag B, Özdemir R, Karapınar T, INCE D, Vergin C (2021). The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. , 362 - 370. 10.31362/patd.815376
Chicago Aydın Sultan,Oymak Yeşim,Meşe Timur,yılmazer murat muhtar,Demirag Bengu,Özdemir Rahmi,Karapınar Tuba Hilkay,INCE Dilek,Vergin Canan The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. (2021): 362 - 370. 10.31362/patd.815376
MLA Aydın Sultan,Oymak Yeşim,Meşe Timur,yılmazer murat muhtar,Demirag Bengu,Özdemir Rahmi,Karapınar Tuba Hilkay,INCE Dilek,Vergin Canan The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. , 2021, ss.362 - 370. 10.31362/patd.815376
AMA Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. . 2021; 362 - 370. 10.31362/patd.815376
Vancouver Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. . 2021; 362 - 370. 10.31362/patd.815376
IEEE Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study." , ss.362 - 370, 2021. 10.31362/patd.815376
ISNAD Aydın, Sultan vd. "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study". (2021), 362-370. https://doi.org/10.31362/patd.815376
APA Aydın S, Oymak Y, Meşe T, yılmazer m, Demirag B, Özdemir R, Karapınar T, INCE D, Vergin C (2021). The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi, 14(2), 362 - 370. 10.31362/patd.815376
Chicago Aydın Sultan,Oymak Yeşim,Meşe Timur,yılmazer murat muhtar,Demirag Bengu,Özdemir Rahmi,Karapınar Tuba Hilkay,INCE Dilek,Vergin Canan The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi 14, no.2 (2021): 362 - 370. 10.31362/patd.815376
MLA Aydın Sultan,Oymak Yeşim,Meşe Timur,yılmazer murat muhtar,Demirag Bengu,Özdemir Rahmi,Karapınar Tuba Hilkay,INCE Dilek,Vergin Canan The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi, vol.14, no.2, 2021, ss.362 - 370. 10.31362/patd.815376
AMA Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi. 2021; 14(2): 362 - 370. 10.31362/patd.815376
Vancouver Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi. 2021; 14(2): 362 - 370. 10.31362/patd.815376
IEEE Aydın S,Oymak Y,Meşe T,yılmazer m,Demirag B,Özdemir R,Karapınar T,INCE D,Vergin C "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study." Pamukkale Tıp Dergisi, 14, ss.362 - 370, 2021. 10.31362/patd.815376
ISNAD Aydın, Sultan vd. "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study". Pamukkale Tıp Dergisi 14/2 (2021), 362-370. https://doi.org/10.31362/patd.815376