Progressive diastolic dysfunction in survivors of pediatric differentiated thyroid carcinoma

Antoinette D. Reichert, Marloes Nies, Wim J.E. Tissing, Anneke C. Muller Kobold, Mariëlle S. Klein Hesselink, Adrienne H. Brouwers, Bas Havekes, Marry M. van den Heuvel-Eibrink, Helena J.H. van der Pal, John T.M. Plukker, Hanneke M. van Santen, Eleonora P.M. Corssmit, Romana T. Netea-Maier, Robin P. Peeters, Eveline W.C.M. van Dam, Johannes G.M. Burgerhof, Peter van der Meer, Gianni Bocca, Thera P. Links*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)497-505
Number of pages9
JournalEuropean Journal of Endocrinology
Volume187
Issue number4
DOIs
Publication statusE-pub ahead of print - 12 Sep 2022

Bibliographical note

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.

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