Left ventricular function in pediatric all survivors using speckle-tracking echocardiography and its relation to N-terminal brain natriuretic peptide

The aim of the present research is to investigate cardiac abnormalities using plasma N-terminal pro brain natriuretic peptide (NT-proBNP) and speckle-tracking echocardiography in asymptomatic pediatric acute lymphoblastic leukemia (ALL) survivors who received cardiotoxic drugs during their treatment. The Institutional Review Board (IRB) of the Menoufia Faculty of Medicine approved the study. Research work was performed in accordance with the Declaration of Helsinki. 40 pediatric ALL survivors and 25 healthy children were enrolled. Complete blood cell count, renal function tests and liver function tests, iron & lipid profile, fasting blood sugar and plasma NT-proBNP level in addition to conventional and speckle-tracking Echocardiography were done. NT-proBNP was highly more significant in survivors than controls. Cardiac parameters as LV global longitudinal systolic peak strain (GLPS) of the three apical views, the GLPS of apical four chamber view (GLPS-A4C), the GLPS of apical two chamber view (GLPS- A2C), the GLPS of apical long axis view (GLPS-LAX), and the “NT-proBNP levels were significantly higher in survivors when compared to controls”. NT-proBNP and 2-D speckle tracking echo show promise in detecting cardiac dysfunction in childhood cancer survivors beyond what is detected by conventional echocardiography. So, it should be added to the follow-up studies of CCS.