Cancer Therapy Effects on the Heart

Study Overview
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Brief Summary
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Anthracycline chemotherapies (e.g. doxorubicin, daunorubicin) are commonly given to treat pediatric cancer, and carry a risk of cardiotoxicity. Over the long term, children who receive these therapies have an increased risk of heart failure and early cardiovascular death. However, current strategies for identifying patients who are at risk prior to the development of significant changes in heart function are limited. This study will focus on imaging markers of cardiac injury and dysfunction with the goal of developing improved diagnostic tests and treatment strategies.

Detailed Description
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Anthracycline chemotherapies (e.g. doxorubicin, daunorubicin) are commonly given to treat pediatric cancer, and carry a risk of cardiotoxicity. Over the long term, children who receive these therapies have an increased risk of heart failure and early cardiovascular death. However, current strategies for identifying patients who are at risk prior to the development of significant changes in heart function are limited. This study will focus on imaging markers of cardiac injury and dysfunction with the goal of developing improved diagnostic tests and treatment strategies. Cardiac remodeling, function, and tissue characteristics will be examined using cardiac MRI data in combination with standard cardiac assessments (by echocardiography, electrocardiograms, and cardiac MRI) to assess the cardiotoxic effects of cancer therapy. Analyses will be performed in a cohort of adolescents and young adults with a history of childhood cancer.

Official Title
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Cancer Therapy Effects on the Heart: Identification of Early Markers of Cardiac Disease Progression After Cardiotoxic Childhood Cancer Therapy Using Cardiac Magnetic Resonance Imaging

Conditions
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Cardiotoxicity, Pediatric Cancer, Heart Failure

Intervention / Treatment
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* Diagnostic Test: Cardiac magnetic resonance imaging (MRI)
* Diagnostic Test: Echocardiography
* Diagnostic Test: Electrocardiogram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: English and Spanish speaking male and female subjects, ages 13-39 years old Diagnosis of cancer at age <22 years Previously treated with anthracyline therapy for cancer, with diagnosis at least two years prior. Exclusion Criteria: Patients who have a contraindication to cardiac MRI, including the presence of non-MRI compatible metallic implants. Medical, psychiatric, and/or social disorder that would prevent successful completion of planned study testing or would preclude the subject from undergoing the cardiac MRI without anesthesia. Patients with a history of congenital heart disease (more significant than a history of patent foramen ovale or patent ductus arteriosus). Patients with orthodontic braces or metallic implants in the thorax or abdomen/lumbar spine, even if MRI-compatible, will be excluded as these may cause artifacts and limit image quality. Pregnancy.

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 39 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| All Study Participants<br>This is an observational study where all study participants are within a single group. | Diagnostic Test: Cardiac magnetic resonance imaging (MRI)<br>* Cardiac magnetic resonance imaging will be performed to evaluate cardiac remodeling, function, and tissue characteristics<br>Diagnostic Test: Echocardiography<br>* Echocardiography, heart ultrasound, will be performed in conjunction with cardiac MRI.<br>Diagnostic Test: Electrocardiogram<br>* Measuring conduction abnormalities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Left ventricular ejection fraction (LVEF) | LVEF is an assessment of left ventricular global systolic function. | 5 years |