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Echocardiography protocol for early detection of cardiac dysfunction in childhood cancer survivors in the multicenter DCCSS LATER 2 CARD study: Design, feasibility, and reproducibility
Author(s) -
Merkx Remy,
Leerink Jan M.,
Feijen Elisabeth Lieke A.M.,
Kremer Leontien C.M.,
de Baat Esmée C.,
Bellersen Louise,
van Dalen Elvira C.,
van Dulmenden Broeder Eline,
van der Heidenvan der Loo Margriet,
van den HeuvelEibrink Marry M.,
Korte Chris L. de,
Loonen Jacqueline,
Louwerens Marloes,
Maas Angela H.E.M.,
Pinto Yigal M.,
Ronckers Cécile M.,
Teske Arco J.,
Tissing Wim J.E.,
de Vries Andrica C.H.,
MavinkurveGroothuis Annelies M.C.,
van der Pal Helena J.H.,
Weijers Gert,
Kok Wouter E.M.,
Kapusta Livia
Publication year - 2021
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.15081
Subject(s) - medicine , ejection fraction , reproducibility , ventricle , cardiology , heart failure , diastole , cardiotoxicity , protocol (science) , radiology , chemotherapy , blood pressure , pathology , statistics , alternative medicine , mathematics
Background Cardiotoxicity is a well‐known side effect after anthracyclines and chest radiotherapy in childhood cancer survivors (CCS). The DCCSS LATER 2 CARD (cardiology) study includes evaluation of echocardiographic measurements for early identification of CCS at highest risk of developing heart failure. This paper describes the design, feasibility, and reproducibility of the echocardiography protocol. Methods Echocardiograms from CCS and sibling controls were prospectively obtained at the participating centers and centrally analyzed. We describe the image acquisition, measurement protocol, and software‐specific considerations for myocardial strain analyses. We report the feasibility of the primary outcomes of systolic and diastolic function, as well as reproducibility analyses in 30 subjects. Results We obtained 1,679 echocardiograms. Biplane ejection fraction (LVEF) measurement was feasible in 91% and 96% of CCS and siblings, respectively, global longitudinal strain (GLS) in 80% and 91%, global circumferential strain (GCS) in 86% and 89%, and ≥2 diastolic function parameters in 99% and 100%, right ventricle free wall strain (RVFWS) in 57% and 65%, and left atrial reservoir strain (LASr) in 72% and 79%. Intra‐class correlation coefficients for inter‐observer variability were 0.85 for LVEF, 0.76 for GLS, 0.70 for GCS, 0.89 for RVFWS and 0.89 for LASr. Intra‐class correlation coefficients for intra‐observer variability were 0.87 for LVEF, 0.82 for GLS, 0.82 for GCS, 0.85 for RVFWS and 0.79 for LASr. Conclusion The DCCSS LATER 2 CARD study includes a protocolized echocardiogram, with feasible and reproducible primary outcome measurements. This ensures high‐quality outcome data for prevalence estimates and for reliable comparison of cardiac function parameters.