18:00 〜 19:00
[P17-05] アントラサイクリン系薬剤関連心機能障害の長軸収縮機能の評価による検出
キーワード：TMAD、Anthracycline、global longitudinal strain
Introduction:Anthracyclines(ATC) have been widely used for the treatment of childhood malignancies, but the dose-dependent cardiotoxicity remains an issue of concern. The importance of assessing the longitudinal systolic function has been acknowledged for early detection of systolic dysfunction. However, there were only few reports to detect the subtle changes of cardiac dysfunction after the additional administration of ATC.Methods:We studied 8 children evaluating the systolic function before and after the additional administration of ATC. Systolic function parameters included conventional M-mode derived LVEF and the longitudinal systolic function such as biplane modified Simpson’s method-derived LVEF, global longitudinal strain(GLS) and tissue motion annular displacement(TMAD). The paired t-test was used to assess the change of these parameters and significance was regarded as a p-value ＜ 0.05.Results:The mean baseline dose was 92.0 ± 32.5 mg/m^2 and the mean additional dose was 150.9 ± 34.7 mg/m^2. M-mode derived LVEF had no significant difference (76.7±4.5 % vs 72.9±7.2 %, p=0.19), but Simpson’s method-derived LVEF (68.0±4.3 % vs 60.1±7.0 %, p=0.03), GLS (-20.3±2.5 % vs -17.0±2.6 %, p=0.01) and TMAD (15.5±2.2 % vs 12.3±3.1 %, p=0.03) significantly decreased after ATC therapy.Discussion;Evaluating only the radial contraction by M-mode method could not detect the subtle depression of systolic function after ATC therapy. It is important to evaluate the longitudinal systolic function for early detection of LV systolic dysfunction after ATC therapy.