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Accuracy of a Novel Handheld Wireless Platform for Detection of Cardiac Dysfunction in Anthracycline-Exposed Survivors of Childhood Cancer

Armenian, Saro H. and Rinderknecht, Derek and Au, Kaylene and Lindenfeld, Lanie and Mills, George and Siyahian, Aida and Herrera, Claudia and Wilson, Karla and Venkataraman, Kalyanasundaram and Mascarenhas, Kristen and Tavallali, Peyman and Razavi, Marianne and Pahlevan, Niema and Detterich, Jon and Bhatia, Smita and Gharib, Morteza (2018) Accuracy of a Novel Handheld Wireless Platform for Detection of Cardiac Dysfunction in Anthracycline-Exposed Survivors of Childhood Cancer. Clinical Cancer Research, 24 (13). pp. 3119-3125. ISSN 1078-0432. doi:10.1158/1078-0432.CCR-17-3599.

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Childhood cancer survivors are at risk for anthracycline-related cardiac dysfunction, often developing at a time when they are least engaged in long-term survivorship care. New paradigms in survivorship care and chronic disease screening are needed in this population. We compared the accuracy of a novel handheld mHealth platform (Vivio) as well as echocardiography for assessment of cardiac function [left ventricular ejection fraction (EF)] in childhood cancer survivors with cardiac magnetic resonance (CMR) imaging (reference). Cross-sectional study design was used. Concurrent evaluation of EF was performed using Vivio, two-dimensional (2D) echocardiography, and CMR. Differences in mean EF (2D echocardiography vs. CMR; Vivio vs. CMR) were compared using Bland-Altman plots. Linear regression was used to evaluate proportional bias. A total of 191 consecutive survivors participated [50.7% female; median time from diagnosis: 15.8 years (2-44); median anthracycline dose: 225 mg/m (25-642)]. Echocardiography overestimated mean EF by 4.9% ( < 0.001); linear regression analysis confirmed a proportional bias, when compared with CMR ( = 3.1, < 0.001). There was no difference between mean EF derived from Vivio and from CMR (-0.2%, = 0.68). The detection of cardiac dysfunction via echocardiography was poor when compared with CMR [Echo EF < 45% (sensitivity 14.3%), Echo EF < 50% (sensitivity 28.6%)]. Sensitivity was substantially better for Vivio-based measurements [EF < 45% or EF < 50% (sensitivity 85.7%)]. This accessible technology has the potential to change the day-to-day practice of clinicians caring for the large number of patients diagnosed with cardiac dysfunction and heart failure each year, allowing real-time monitoring and management of their disease without the lag-time between imaging and interpretation of results.

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Gharib, Morteza0000-0002-2204-9302
Additional Information:© 2018 American Association for Cancer Research. Received December 1, 2017. Revision received January 15, 2018. Accepted March 6, 2018. Published first June 21, 2018. Presented, in part, at the International Conference on Long Term Complications of Treatment of Children and Adolescents for Cancer (2017). This study was supported, in part, by grants from the Caltech-City of Hope Biomedical Research Initiative (Armenian, Gharib) and Leukemia & Lymphoma Society Scholar Award for Clinical Research (Armenian). Authors' Contributions: Conception and design: S.H. Armenian, D. Rinderknecht, P. Tavallali, N. Pahlevan, S. Bhatia, M. Gharib Development of methodology: S.H. Armenian, D. Rinderknecht, P. Tavallali, N. Pahlevan, J. Detterich Acquisition of data (provided animals, acquired and managed patients, provided facilities, etc.): S.H. Armenian, D. Rinderknecht, K. Au, G. Mills, A. Siyahian, K. Wilson, K. Venkataraman, K. Mascarenhas, J. Detterich Analysis and interpretation of data (e.g., statistical analysis, biostatistics, computational analysis): S.H. Armenian, D. Rinderknecht, P. Tavallali, M. Razavi, N. Pahlevan, J. Detterich, S. Bhatia Writing, review, and/or revision of the manuscript: S.H. Armenian, D. Rinderknecht, K. Au, N. Pahlevan, J. Detterich, S. Bhatia Administrative, technical, or material support (i.e., reporting or organizing data, constructing databases): S.H. Armenian, D. Rinderknecht, K. Au, L. Lindenfeld, A. Siyahian Study supervision: S.H. Armenian, M. Gharib The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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Caltech-City of Hope Biomedical InitiativeUNSPECIFIED
Leukemia and Lymphoma SocietyUNSPECIFIED
Issue or Number:13
Record Number:CaltechAUTHORS:20180626-131238197
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Official Citation:Accuracy of a Novel Handheld Wireless Platform for Detection of Cardiac Dysfunction in Anthracycline-Exposed Survivors of Childhood Cancer Saro H. Armenian, Derek Rinderknecht, Kaylene Au, Lanie Lindenfeld, George Mills, Aida Siyahian, Claudia Herrera, Karla Wilson, Kalyanasundaram Venkataraman, Kristen Mascarenhas, Peyman Tavallali, Marianne Razavi, Niema Pahlevan, Jon Detterich, Smita Bhatia, and Morteza Gharib Clin Cancer Res July 1 2018 (24) (13) 3119-3125; DOI: 10.1158/1078-0432.CCR-17-3599
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:87350
Deposited By: George Porter
Deposited On:26 Jun 2018 20:24
Last Modified:15 Nov 2021 20:47

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