Antrasiklinlerle tedavi edilen çocukluk çağı kanserlerinde kalp fonksiyonlarının ekokardiyografi ve GDF-15 (growth-differentiation factor-15) ile değerlendirilmesi
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Dosyalar
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, tedavi şemalarında antrasiklin olan kanserli çocuk hastalarda gelişebilecek kardiyotoksisitenin erken saptanmasında serum GDF-15 düzeyinin kullanılabilirliği planlandı. Hastalar ve Metod: Tedavi şemasında antrasiklin olan 20 hasta çalışmaya dâhil edildi. Hastaların değerlendirilmeleri tanı anında, kümülatif antrasiklin dozu 100, 200, 300 mg/m2 ye ulaştığında ve tedavi bitiminden 6 ay sonrasında yapıldı. değerlendirmeler anamnez, fizik muayene, ekokardiyografi, Doppler ekokardiyografi, serum troponin-I ve GDF-15 ile yapıldı. Bulgular: Hastaların yaşı 3 ile 18 yıl arasında değişiyordu (ortanca 14 yıl). On üç hasta erkek (%65) ve 7 hasta kız idi (%35). Aldıkları antrasiklin kümülatif dozları 60-400 mg/m2 oranında (ortanca 220 mg/m2) değişiyordu. Tanı anındaki ile antrasiklin maruziyeti sonrasında ölçülen sol ventrikül sistolik fonksiyonları arasında istatistiksel olarak anlamlı fark gözlenmedi (p>0,005). Doku Doppler ekokardiyografide bakılan Tei indeksi (MPI) ise çalışmamızda antrasiklinin 300 mg/m2 alımı sonrası ile antrasiklin tedavi bitiminden 6 ay sonraki dönemde bakılan sağ Tei indeksi ile kıyaslandığında anlamlı korelasyon bulundu (r:0,596, p<0,05). Serum GDF-15 düzeyinin ise tanı anı ile antrasiklinin kümülatif 200 mg/m2? e maruziyeti sonrasında tedavi öncesine göre istatistiksel olarak fark saptandı (p<0,05). Tanı anı ile antrasiklin maruziyet sonrasında bakılan troponin-I düzeyleri arasında istatistiksel olarak fark saptanmadı (p>0,05). Sonuç: Çalışmamız doku Doppler ekokardiyografi ile serum GDF-15? in subklinik kardiyotoksisiteyi saptamada duyarlı bir yöntem olabileceğini göstermiştir.
Aim: In this study, the availability of blood levels of GDF-15 in the early detection of possible cardiotoxicity development in children with cancer who received anthracycline at stages of treatment was planned. Patients and Method: Twenty patients who received anthracycline at stages of treatment were included in this study. The evaluation of patients are carried out at the time of diagnosis, at anthracycline cumulative dose of 100 mg/m2, 200 mg/m2, 300 mg/m2 and six months after the end of therapy. In the evaluations; history of the patient, physical examination, echocardiography, Doppler echocardiography, serum troponin-I and GDF-15 were used. Results: Age of the patients ranged from 3 to 18 years (median 14 years). Thirteen patients were male (65%) and seven patients were female (35%). Cumulative doses of anthracycline received by the patients were ranged from 60 mg/m2 to 400 mg/m2 (median 220 mg/m2) There was no statistically significant difference between the measured left ventricular systolic function at the time of diagnosis and at the end of the anthracycline exposure (p>0,005). In this study, there is a significant correlation between the Tei index (viewed in the Tissue Doppler echocardiography) which is measured after the ingestion of 300 mg/m2 anthracycline and after six months from the termination of anthracycline treatment (r:0.596, p<0.05). The difference was statistically significant compared with pretreatment values in the level of serum GDF-15 which is measured at the time of diagnosis and at the cumulative anthracycline exposure of 200 mg/m2 (p<0,05). There was no statistically significant difference between the levels of troponin-I which is measured at the time of diagnosis and which is measured after the anthracycline exposure (p> 0,05). Conclusion: This study shows that both the tissue Doppler echocardiography and the serum GDF-15 can be sensitive methods for detecting subclinical cardiotoxicity.
Aim: In this study, the availability of blood levels of GDF-15 in the early detection of possible cardiotoxicity development in children with cancer who received anthracycline at stages of treatment was planned. Patients and Method: Twenty patients who received anthracycline at stages of treatment were included in this study. The evaluation of patients are carried out at the time of diagnosis, at anthracycline cumulative dose of 100 mg/m2, 200 mg/m2, 300 mg/m2 and six months after the end of therapy. In the evaluations; history of the patient, physical examination, echocardiography, Doppler echocardiography, serum troponin-I and GDF-15 were used. Results: Age of the patients ranged from 3 to 18 years (median 14 years). Thirteen patients were male (65%) and seven patients were female (35%). Cumulative doses of anthracycline received by the patients were ranged from 60 mg/m2 to 400 mg/m2 (median 220 mg/m2) There was no statistically significant difference between the measured left ventricular systolic function at the time of diagnosis and at the end of the anthracycline exposure (p>0,005). In this study, there is a significant correlation between the Tei index (viewed in the Tissue Doppler echocardiography) which is measured after the ingestion of 300 mg/m2 anthracycline and after six months from the termination of anthracycline treatment (r:0.596, p<0.05). The difference was statistically significant compared with pretreatment values in the level of serum GDF-15 which is measured at the time of diagnosis and at the cumulative anthracycline exposure of 200 mg/m2 (p<0,05). There was no statistically significant difference between the levels of troponin-I which is measured at the time of diagnosis and which is measured after the anthracycline exposure (p> 0,05). Conclusion: This study shows that both the tissue Doppler echocardiography and the serum GDF-15 can be sensitive methods for detecting subclinical cardiotoxicity.
Açıklama
Anahtar Kelimeler
Antrasiklin kardiyotoksisitesi, Anthracycline cardiotoxicity, Doku Doppler görüntüleme, Tissue Doppler imaging, GDF-15
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kaya, F. (2013). Antrasiklinlerle tedavi edilen çocukluk çağı kanserlerinde kalp fonksiyonlarının ekokardiyografi ve GDF-15 (growth-differentiation factor-15) ile değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış tıpta uzmanlık tezi, Konya.
