PMID- 32269016
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1929-0748 (Print)
IS  - 1929-0748 (Electronic)
IS  - 1929-0748 (Linking)
VI  - 9
IP  - 6
DP  - 2020 Jun 10
TI  - Diagnosing Preclinical Cardiac Dysfunction in Swiss Childhood Cancer Survivors: 
      Protocol for a Single-Center Cohort Study.
PG  - e17724
LID - 10.2196/17724 [doi]
LID - e17724
AB  - BACKGROUND: Cardiovascular disease is the leading nonmalignant cause of late 
      deaths in childhood cancer survivors. Cardiovascular disease and cardiac 
      dysfunction can remain asymptomatic for many years, but eventually lead to 
      progressive disease with high morbidity and mortality. Early detection and 
      intervention are therefore crucial to improve outcomes. OBJECTIVE: In our study, 
      we aim to assess the prevalence of preclinical cardiac dysfunction in adult 
      childhood cancer survivors using conventional and speckle tracking 
      echocardiography; determine the association between cardiac dysfunction and 
      treatment-related risk factors (anthracyclines, alkylating agents, steroids, 
      cardiac radiation) and modifiable cardiovascular risk factors (abdominal obesity, 
      hypertension); investigate the development of cardiac dysfunction longitudinally 
      in a defined cohort; study the association between cardiac dysfunction and other 
      health outcomes like pulmonary disease, endocrine disease, renal disease, quality 
      of life, fatigue, strength and endurance, and physical activity; and gain 
      experience conducting a clinical study of childhood cancer survivors that will be 
      extended to a national, multicenter study of cardiac complications. METHODS: For 
      this retrospective cohort study, we will invite >/=5-year childhood cancer 
      survivors who were treated at the University Children's Hospital Bern, 
      Switzerland with any chemotherapy or cardiac radiation since 1976 and who are >/=18 
      years of age at the time of the study for a cardiac assessment at the University 
      Hospital Bern. This includes 544 childhood cancer survivors, of whom about half 
      were treated with anthracyclines and/or cardiac radiation and half with any other 
      chemotherapy. The standardized cardiac assessment includes a medical history 
      focusing on signs of cardiovascular disease and its risk factors, a physical 
      examination, anthropometry, vital parameters, the 1-minute sit-to-stand test, and 
      echocardiography including 2-dimensional speckle tracking. RESULTS: We will 
      invite 544 eligible childhood cancer survivors (median age at the time of the 
      study, 32.5 years; median length of time since diagnosis, 25.0 years) for a 
      cardiac assessment. Of these survivors, 300 (55%) are at high risk, and 244 (45%) 
      are at standard risk of cardiac dysfunction. CONCLUSIONS: This study will 
      determine the prevalence of preclinical cardiac dysfunction in Swiss childhood 
      cancer survivors, inform whether speckle tracking echocardiography is more 
      sensitive to cardiac dysfunction than conventional echocardiography, and give a 
      detailed picture of risk factors for cardiac dysfunction. The results will help 
      improve primary treatment and follow-up care of children with cancer. TRIAL 
      REGISTRATION: ClinicalTrials.gov NCT03790943; 
      https://clinicaltrials.gov/ct2/show/NCT03790943. INTERNATIONAL REGISTERED REPORT 
      IDENTIFIER (IRRID): DERR1-10.2196/17724.
CI  - (c)Christina Schindera, Claudia Elisabeth Kuehni, Mladen Pavlovic, Eva Simona 
      Haegler-Laube, Daniel Rhyner, Nicolas Waespe, Jochen Roessler, Thomas Suter, 
      Nicolas Xavier von der Weid. Originally published in JMIR Research Protocols 
      (http://www.researchprotocols.org), 10.06.2020.
FAU - Schindera, Christina
AU  - Schindera C
AUID- ORCID: 0000-0002-4511-287X
AD  - Childhood Cancer Registry, Institute of Social and Preventive Medicine, 
      University of Bern, Bern, Switzerland.
AD  - Pediatric Oncology/Hematology, University Children's Hospital Basel, University 
      of Basel, Basel, Switzerland.
FAU - Kuehni, Claudia Elisabeth
AU  - Kuehni CE
AUID- ORCID: 0000-0001-8957-2002
AD  - Childhood Cancer Registry, Institute of Social and Preventive Medicine, 
      University of Bern, Bern, Switzerland.
AD  - Pediatric Hematology and Oncology, University Children's Hospital Bern, 
      University of Bern, Bern, Switzerland.
FAU - Pavlovic, Mladen
AU  - Pavlovic M
AUID- ORCID: 0000-0002-8334-6706
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Haegler-Laube, Eva Simona
AU  - Haegler-Laube ES
AUID- ORCID: 0000-0003-0745-5035
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Rhyner, Daniel
AU  - Rhyner D
AUID- ORCID: 0000-0001-5353-9673
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Waespe, Nicolas
AU  - Waespe N
AUID- ORCID: 0000-0002-2271-8959
AD  - Childhood Cancer Registry, Institute of Social and Preventive Medicine, 
      University of Bern, Bern, Switzerland.
AD  - Platform of Pediatric Onco-Hematology research, CANSEARCH Laboratory, Department 
      of Pediatrics, Gynecology, and Obstetrics, University of Geneva, Geneva, 
      Switzerland.
FAU - Roessler, Jochen
AU  - Roessler J
AUID- ORCID: 0000-0003-4022-4917
AD  - Pediatric Hematology and Oncology, University Children's Hospital Bern, 
      University of Bern, Bern, Switzerland.
FAU - Suter, Thomas
AU  - Suter T
AUID- ORCID: 0000-0003-2158-2479
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - von der Weid, Nicolas Xavier
AU  - von der Weid NX
AUID- ORCID: 0000-0002-9555-3817
AD  - Pediatric Oncology/Hematology, University Children's Hospital Basel, University 
      of Basel, Basel, Switzerland.
LA  - eng
SI  - ClinicalTrials.gov/NCT03790943
PT  - Journal Article
DEP - 20200610
PL  - Canada
TA  - JMIR Res Protoc
JT  - JMIR research protocols
JID - 101599504
PMC - PMC7315371
OTO - NOTNLM
OT  - Switzerland
OT  - alkylating agents
OT  - anthracyclines
OT  - cardiac radiation
OT  - cardiotoxicity
OT  - echocardiography
OT  - speckle tracking
OT  - steroids
OT  - strain
COIS- Conflicts of Interest: JR reports personal fees from SOBI, Roche, and Pierre 
      Fabre for advisory board membership, which is independent of the submitted work.
EDAT- 2020/04/10 06:00
MHDA- 2020/04/10 06:01
PMCR- 2020/06/10
CRDT- 2020/04/10 06:00
PHST- 2020/01/08 00:00 [received]
PHST- 2020/04/07 00:00 [accepted]
PHST- 2020/04/06 00:00 [revised]
PHST- 2020/04/10 06:00 [pubmed]
PHST- 2020/04/10 06:01 [medline]
PHST- 2020/04/10 06:00 [entrez]
PHST- 2020/06/10 00:00 [pmc-release]
AID - v9i6e17724 [pii]
AID - 10.2196/17724 [doi]
PST - epublish
SO  - JMIR Res Protoc. 2020 Jun 10;9(6):e17724. doi: 10.2196/17724.