TY - JOUR
T1 - Progressive diastolic dysfunction in survivors of pediatric differentiated thyroid carcinoma
AU - Reichert, Antoinette D
AU - Nies, Marloes
AU - Tissing, Wim J E
AU - Muller Kobold, Anneke C
AU - Klein Hesselink, Mariëlle S
AU - Brouwers, Adrienne H
AU - Havekes, Bas
AU - van den Heuvel-Eibrink, Marry M
AU - van der Pal, Helena J H
AU - Plukker, John T M
AU - van Santen, Hanneke M
AU - Corssmit, Eleonora P M
AU - Netea-Maier, Romana T
AU - Peeters, Robin P
AU - van Dam, Eveline W C M
AU - Burgerhof, Johannes G M
AU - van der Meer, Peter
AU - Bocca, Gianni
AU - Links, Thera P
N1 - Funding Information:
This study was funded by Stichting Kinderen Kankervrij (Foundation Children Cancer-Free, the Netherlands, project no. 81), the Van der Meer-Boerema Foundation, and the Junior Scientific Masterclass Groningen.
Publisher Copyright:
© 2022 European Society of Endocrinology Printed in Great Britain Published by Bioscientifica Ltd.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: Pediatric differentiated thyroid cancer (DTC) has an excellent prognosis but unknown late effects of treatment. The initial cardiac evaluation showed subclinical diastolic dysfunction in 20% of adult survivors. The objective of this follow-up study was to determine the clinical course of this finding.Methods: This multicenter study, conducted between 2018 and 2020, re-evaluated survivors after 5 years. The primary endpoint was echocardiographic diastolic cardiac function (depicted by the mean of the early diastolic septal and early diastolic lateral tissue velocity (e' mean)). Secondary endpoints were other echocardiographic parameters and plasma biomarkers.Results: Follow-up evaluation was completed in 47 (71.2%) of 66 survivors who had completed their initial evaluation. Of these 47 survivors, 87.2% were women. The median age was 39.8 years (range: 18.8-60.3), and the median follow-up after the initial diagnosis was 23.4 years (range: 10.2-48.8). Between the first and second evaluation, the e' mean significantly decreased by 2.1 cm/s (s.d. 2.3 cm/s, P < 0.001). The median left ventricular ejection fraction did not significantly change (58.0% vs 59.0%, P= NS). In the best explanatory model of e' mean, multivariate linear regression analysis showed that BMI and age were significantly associated with e' mean (β coefficient: -0.169, 95% CI: -0.292; -0.047, P = 0.008 and β coefficient: -0.177, 95% CI: -0.240; -0.113, P < 0.001, respectively).Conclusions and relevance: In these relatively young survivors of pediatric DTC, diastolic function decreased significantly during 5-year follow-up and is possibly more pronounced than in normal aging. This finding requires further follow-up to assess clinical consequences.
AB - Background: Pediatric differentiated thyroid cancer (DTC) has an excellent prognosis but unknown late effects of treatment. The initial cardiac evaluation showed subclinical diastolic dysfunction in 20% of adult survivors. The objective of this follow-up study was to determine the clinical course of this finding.Methods: This multicenter study, conducted between 2018 and 2020, re-evaluated survivors after 5 years. The primary endpoint was echocardiographic diastolic cardiac function (depicted by the mean of the early diastolic septal and early diastolic lateral tissue velocity (e' mean)). Secondary endpoints were other echocardiographic parameters and plasma biomarkers.Results: Follow-up evaluation was completed in 47 (71.2%) of 66 survivors who had completed their initial evaluation. Of these 47 survivors, 87.2% were women. The median age was 39.8 years (range: 18.8-60.3), and the median follow-up after the initial diagnosis was 23.4 years (range: 10.2-48.8). Between the first and second evaluation, the e' mean significantly decreased by 2.1 cm/s (s.d. 2.3 cm/s, P < 0.001). The median left ventricular ejection fraction did not significantly change (58.0% vs 59.0%, P= NS). In the best explanatory model of e' mean, multivariate linear regression analysis showed that BMI and age were significantly associated with e' mean (β coefficient: -0.169, 95% CI: -0.292; -0.047, P = 0.008 and β coefficient: -0.177, 95% CI: -0.240; -0.113, P < 0.001, respectively).Conclusions and relevance: In these relatively young survivors of pediatric DTC, diastolic function decreased significantly during 5-year follow-up and is possibly more pronounced than in normal aging. This finding requires further follow-up to assess clinical consequences.
KW - Adult
KW - Child
KW - Diastole
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Stroke Volume
KW - Survivors
KW - Thyroid Neoplasms
KW - Ventricular Dysfunction, Left
KW - Ventricular Function, Left
U2 - 10.1530/EJE-22-0094
DO - 10.1530/EJE-22-0094
M3 - Article
C2 - 35947635
SN - 0804-4643
VL - 187
SP - 497
EP - 505
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 4
ER -