Cancer Control Research
7R01CA079060-06
Lipshultz, Steven E.
CARDIAC RISK FACTORS IN PEDIATRIC CANCER SURVIVORS
AbstractDESCRIPTION: (Applicant's Description)
Although subclinical cardiac abnormalities are common and often progressive
in long-term survivors of childhood cancer who have been treated with
anthracycline chemotherapy or mediastinal irradiation, a comprehensive
assessment of risk factor for premature symptomatic cardiovascular disease
has never been performed. The relationship between emerging late effects of
treatment (lipid abnormalities, obesity, and cardiomyopathy) warrants
further study. In this application, the investigators will study and
identify a comprehensive cardiac risk factor profile on all eligible
long-term survivors of childhood cancer within the catchment area of upstate
New York. The primary hypothesis is that these patients will have more risk
factors for subsequent symptomatic cardiovascular disease than two control
populations that will be studied. The first will be matched siblings of
treated patients, and the second will be long-term survivors of childhood
cancer who have not been treated with therapy known to be cardiotoxic. The
investigators will be able to determine whether there are increased risk
factors and whether these risk factors are related to prior oncologic
therapy. The second hypothesis is that there are differences in the number
of cardiac risk factors for three groups of long-term survivors: those
treated with anthracyclines alone, those treated with radiation to the heart
alone, and those treated with both. The applicants will specifically
determine the presence of depressed left ventricular (LV) function, thin LV
wall, elevated LV afterload, increased body fat, elevated blood pressure,
abnormal endothelial function, and abnormal lipid profiles. These will be
compared to the control populations. Other secondary risk factors will be
determined. Longitudinal changes in study and control patients will be
determined as well to chart the trajectory over time in risk factors in
different populations. If the hypotheses are true, this should enable more
rational recommendations for preventive cardiology in long-term survivors to
be made and to standardize care and management for this population.
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