الفهرس 
Introduction& Aim of the workOnly 14 pages are availabe for public view
 |  | from | 103 |  |  |
| | | from | 103 | | |
Abstract
This study aims to study the role of tissue Doppler imaging (TDI) with myeloperoxidase enzyme in detection of subclinical cardiotoxicity in childhood cancer survivors. This study was held in the hematology, oncology and echocardiographic units of pediatric department, Zagazig University. It was a case- control study with 90 child equally subdivided into a case group and a control group. Case group included 45 children with childhood hematologic malignancy or solid tumor that were given anthracycline in their treatment and complete their course. Control group included 45 children that age and sex matched with the cases. All patients and controls were subjected to complete history taking and evaluation of subclinical cardiotoxicity by conventional echocardiography, tissue Doppler imaging and MPO enzyme level analysis. Our patient group showed a statistically significant decrease in the systolic function. Ejection fraction (EF) and fractional shortening (FS) were decreased as compared to the control group. Although the difference is statistically significant the values are still within the normal range. In our survivors, the cardiotoxicity detected by standard echocardiography regarding cardiac diastolic function there were statistically high significant differences between studied cases and control groups regarding MV E and MV A. However, the MV E/A ratio not affected. Measuring LVIDd in our study showed no statistically significant differences between the cases and control groups. In our TDI study, regarding mitral annulus there was a statistically significant decrease in systolic (S`) and both early and late diastolic (E` & A`) detected with pulsed wave Doppler on both septal and lateral leaflets. Concerning to systolic function in our TDI study, when interventricular septum and lateral walls were investigated there was significant decrease in systolic function in mid portion of the septum and lateral walls. Also when diastolic functions were evaluated, our data demonstrated signs of affection of these functions in the form of decrease in almost all portions of interventricular septum and lateral walls except early diastolic functions of mid portion of septum and late diastolic functions of basal portion of the lateral walls where there were no significant difference between cases and control groups. In the current work, MPO level was investigated in childhood cancer survivors. There was a highly significant increase in MPO level in survivors as compared to control. When we correlate between MPO level and echocardiographic findings of the studied groups, there was negative correlation between MPO and diastolic functions as detected by MV E and MV A but not with MV E/A ratio. However, there were no significant correlations between MPO level and systolic functions represented by EF, FS. Also there was no correlation between MPO and LVIDd. On the other hand, when we correlate between MPO and TDI findings of the studied groups regarding mitral annular velocity there was negative correlation between MPO and systolic, early and late diastolic velocities. Also there was high significant correlation between all portions of septal and lateral velocities except systolic velocity in lateral basal portion, pulsed septal E/Eꞌ and pulsed lateral E/Eꞌ that were non-significant. from these correlations we observed that MPO is a good predictor for both systolic and diastolic dysfunction detected by TDI.