The landscape of cardiovascular care in pediatric cancer patients and survivors: a survey by the ACC Pediatric Cardio-Oncology Work Group.

Abstract

OBJECTIVE:

To enhance the understanding of cardiovascular care delivery in childhood cancer patients and survivors.

STUDY DESIGN:

A 20-question survey was created by the Pediatric Cardio-oncology Work Group of the American College of Cardiology (ACC) Cardio-oncology Section to assess the care, management, and surveillance tools utilized to manage pediatric/young adult cardio-oncology patients. The survey distribution was a collaborative effort between Cardio-oncology Section and membership of the Adult Congenital and Pediatric Cardiology Section (ACPC) of the ACC.

RESULTS:

Sixty-five individuals, all self-identified as physicians, responded to the survey. Most respondents (n = 58,89%) indicated childhood cancer patients are regularly screened prior to and during cancer therapy at their centers, predominantly by electrocardiogram (75%), standard echocardiogram (58%) and advanced echocardiogram (50%) (i.e. strain, stress echo). Evaluation by a cardiologist prior to/during therapy was reported by only 8(12%) respondents, as compared to post-therapy which was reported by 28 (43%, p < 0.01). The most common indications for referral to cardiology at pediatric centers were abnormal test results (n = 31,48%) and history of chemotherapy exposure (n = 27,42%). Of note, during post-treatment counseling, common cardiovascular risk-factors like blood pressure (31,48%), lipid control (22,34%), obesity & smoking (30,46%) and diet/exercise/weight loss (30,46%) were addressed by fewer respondents than was LV function (72%).

CONCLUSIONS:

The survey data demonstrates that pediatric cancer patients are being screened by EKG and/or imaging prior to/during therapy at most centers. Our data, however, highlight the potential for greater involvement of a cardiovascular specialist for pre-treatment evaluation process, and for more systematic cardiac risk factor counseling in posttreatment cancer survivors.

• Authors: Thomas D Ryan, William L Border, Carissa Baker-Smith, Ana Barac, Matthew J Bock, Mary M Canobbio, Nadine F Choueiter, Devyani Chowdhury, Katheryn E Gambetta, Julie S Glickstein, Lavanya Kondapalli, Seema Mital, Vasum Peiris, Russell J Schiff, Robert L Spicer, Jeffrey A Towbin, Ming Hui Chen
• Journal: Cardio-oncology (London, England) (Cardiooncology) Vol. 5 Pg. 16 ( 2019) ISSN: 2057-3804 [Electronic] England
• PMID: 32154022 (Publication Type: Journal Article)
• Copyright: © The Author(s). 2019.