TY - JOUR
T1 - The landscape of cardiovascular care in pediatric cancer patients and survivors
T2 - A survey by the ACC Pediatric Cardio-Oncology Work Group
AU - Ryan, Thomas D.
AU - Border, William L.
AU - Baker-Smith, Carissa
AU - Barac, Ana
AU - Bock, Matthew J.
AU - Canobbio, Mary M.
AU - Choueiter, Nadine F.
AU - Chowdhury, Devyani
AU - Gambetta, Katheryn E.
AU - Glickstein, Julie S.
AU - Kondapalli, Lavanya
AU - Mital, Seema
AU - Peiris, Vasum
AU - Schiff, Russell J.
AU - Spicer, Robert L.
AU - Towbin, Jeffrey A.
AU - Chen, Ming Hui
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/10/23
Y1 - 2019/10/23
N2 - 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.
AB - 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.
KW - ACC
KW - Cancer
KW - Cardiac risk factors
KW - Cardio-oncology
KW - Cardiology
KW - Echocardiography
KW - Pediatrics
KW - Survey
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U2 - 10.1186/s40959-019-0051-8
DO - 10.1186/s40959-019-0051-8
M3 - Article
AN - SCOPUS:85087183652
SN - 2057-3804
VL - 5
JO - Cardio-Oncology
JF - Cardio-Oncology
IS - 1
M1 - 16
ER -
