Huber F, Schöffl I, Müller N, Dierl A, Wild EM, Naumann-Bartsch N, Karow A, Knieling F, Wölfle J, Dittrich S, Anderheiden F (2025)
Publication Type: Journal article
Publication year: 2025
Book Volume: 184
Article Number: 406
Journal Issue: 7
DOI: 10.1007/s00431-025-06243-0
Childhood survivors of acute lymphoblastic leukemia (ALL) and Hodgkin disease (HD) are at risk of long-term cardiopulmonary impairments due to cardiotoxic chemotherapy and inactivity. This study aims to assess the cardiopulmonary fitness and cardiac function of pediatric cancer survivors (PCS) using cardiopulmonary exercise testing (CPET) and echocardiography, including strain imaging, to determine the extent of functional limitations and their underlying causes. This prospective, single-center study included 27 PCS (21 with ALL, 6 with HD) and 27 age-matched healthy controls. Participants underwent echocardiography with strain analysis and CPET on a treadmill to evaluate cardiac function and exercise capacity. Key parameters such as ejection fraction (EF), global longitudinal strain (GLS), E/E′ ratio, peak oxygen uptake (V˙O2peak), and breathing efficiency were analyzed. PCS exhibited significantly lower V˙O2peak compared to controls (38.3 ± 7.7 ml/kg/min vs. 46.4 ± 5.4 ml/kg/min, p = 0.001), along with a reduced peak heart rate (p = 0.001). Echocardiographic analysis showed that while EF and GLS remained within normal ranges, E/E′ septal was significantly elevated (p = 0.001). Pulmonary parameters did not indicate significant ventilatory limitations. Conclusion: Our study underscores the importance of diastolic assessments and advanced echocardiographic techniques in monitoring PCS, with E/E′ septal emerging as a key marker. CPET provides valuable insights into the functional impact of early cardiac changes. Despite signs of diastolic dysfunction at rest, stroke volume and pulmonary function were preserved during exercise, suggesting that detraining may partly contribute to reduced V˙O2peak. Trail registration: NCT06093334. (Table presented.)
APA:
Huber, F., Schöffl, I., Müller, N., Dierl, A., Wild, E.-M., Naumann-Bartsch, N.,... Anderheiden, F. (2025). What about the heart — pediatric ALL survivors show cardiopulmonary limitations in the MinimALL Study. European Journal of Pediatrics, 184(7). https://doi.org/10.1007/s00431-025-06243-0
MLA:
Huber, Felix, et al. "What about the heart — pediatric ALL survivors show cardiopulmonary limitations in the MinimALL Study." European Journal of Pediatrics 184.7 (2025).
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