ETA2022 Oral Presentations Oral Session 12: Nodules and Diagnostic (5 abstracts)
Progressive diastolic dysfunction in survivors of pediatric differentiated thyroid carcinoma
Antoinette Reichert 1 , Marloes Nies 2 , wim tissing 3 , Anneke Muller Kobold 4 , Marielle Klein Hesselink 5 , A.H. Brouwers 6 , Bastiaan Havekes 7 , marry van den heuvel-eibrink 8 , helena van der pal 9 , john plukker 10 , Hanneke Van Santen 11 , eleonora corssmit 12 , Romana Teodora Netea-Maier 13 , Robin Peeters 14 , Eveline van Dam 15 , johannes burgerhof 16 , Peter van der Meer 17 , gianni bocca 18 & Thera Links 19
1University Medical Center Groningen, Internal Medicine, Netherlands; 2University of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, Netherlands; 3University of Groningen, Beatrix Children’s Hospital, Paediatric Oncology, University Medical Center Groningen, Groningen, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, Pediatric Oncology; 4University Medical Center Groningen, University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, Groningen, the Netherlands.*, Department of Laboratory Medicine, Groningen, Netherlands; 5Department of Endocrinology, University Medical Center Groningen, Groningen, Netherlands; 6University Medical Center Groningen, University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging Groningen, Groningen, Netherlands; 7Mumc, Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, the Netherlands, Maastricht, Netherlands; 8Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, the Netherlands, Department of Pediatric Oncology, Utrecht, Netherlands; 9Princess Maxima Center of Pediatric Oncology, Utrecht, the Netherlands, Netherlands; 10University of Groningen, University Medical Center Groningen, Department of Surgical Oncology, Groningen, the Netherlands, Netherlands; 11Wilhelmina Children’s Hospital and Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands, Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands, Department of Supportive Care, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands, Utrecht, Netherlands; 12Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, Paediatric Oncology, Emma Children’s Hospital, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; 13Radboud University Medical Centre, Dept. of Endocrinology, Nijmegen, Netherlands; 14Academic Center for Thyroid Diseases, Department of Endocrinology, Erasmus, Department of Internal Medicine,, Rotterdam, Netherlands; 15Amsterdam University Medical Center, Vu University Medical Center, Department of Internal Medicine, Division of Endocrinology, Amsterdam, Netherlands; 16University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands.; 17University Medical Center Groningen, Amsterdam, Netherlands; 18University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Pediatric Endocrinology, Groningen, the Netherlands; 19University Medical Center Groningen, Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Department of Endocrinology, Groningen, Netherlands
Background: Pediatric differentiated thyroid cancer (DTC) has an excellent prognosis, but has unknown late effects of treatment. Initial cardiac evaluation showed subclinical diastolic dysfunction in 20% of adult survivors. In this follow-up study, we determined the clinical course of this finding.
Methods: This multicenter study, conducted between 2018 and 2020, re-evaluated survivors 5 years after the first evaluation. The primary endpoint was echocardiographic diastolic cardiac function (depicted by the mean of 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%) survivors. Of these 47 survivors (87.2%) were women, median age 39.8 years (range 18.8-60.3). The median follow-up after 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 (SD 2.3 cm/s, P<0.001). The median left ventricular ejection fraction did not significantly change (58.0% vs. 59.0%, NS). In the best explanatory model of e’ mean, multivariate linear regression analysis showed that body mass index and age were significantly associated with e’ mean (β coefficient -0.169, 95% confidence interval (CI) [-0.292;-0.047], P=0.008 and β coefficient -0.177, 95% CI [-0.240;-0.113], P<0.001, respectively). The TSH value was not significantly associated with the e’ mean.
Conclusions and relevance: In these relatively young survivors of pediatric DTC, diastolic function decreased significantly during 5 year follow up, possibly more pronounced than in normal ageing. This finding requires further follow-up to assess clinical consequences.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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