Cardiovascular Function Evaluation of Childhood Cancer Survivors During Post-Treatment Follow-Up

Objective: To characterize cardiovascular findings in childhood cancer survivors during post-treatment follow-up. Methods: This single-center observational study assessed survivors after completion of treatment and compared available echocardiographic and exercise-related measurements with healthy control data. Clinical assessment, cardiac biomarkers and electrocardiography were also obtained. Receipt of cardiovascular medication at follow-up was examined as an exploratory clinical management outcome. Results: Sixty survivors and 60 healthy controls contributed echocardiographic data; CPET comparisons involved 42 survivors and 14 controls. The median survivor age was 12 years. No survivor had clinical heart failure symptoms. Compared with controls, survivors had higher heart rate and resting blood pressure, less negative LV GLS (−18.8 ± 2.5% vs. −22.5 ± 1.6%), higher mitral E/e (6.2 (5.5, 7.1) vs. 4.9 (4.4, 5.7)), and lower recorded absolute oxygen uptake during exercise (1.2 (0.9, 1.4) vs. 1.5 (1.3, 1.7) L/min). Qualitative cardiac enlargement was reported in 16 survivors; 15 received cardiovascular medication. Previous cardiac events were associated with medication receipt in univariate analysis. In the ALL subgroup, medication receipt was more frequent in the intermediate/high-risk treatment group, which had higher anthracycline exposure; the age-at-diagnosis comparison was not statistically significant (p = 0.054). Conclusions: Selected cardiovascular measurements differed between survivors and healthy controls, suggesting possible subclinical alterations. These findings do not establish clinically defined cardiac dysfunction or a causal effect of cancer treatment. The unadjusted absolute oxygen uptake comparison does not establish impaired exercise capacity. Treatment-related associations were exploratory and did not identify independent predictors.