|Grant Number:||7R01CA079060-06 Interpret this number|
|Primary Investigator:||Lipshultz, Steven|
|Organization:||University Of Miami School Of Medicine|
|Project Title:||Cardiac Risk Factors in Pediatric Cancer Survivors|
DESCRIPTION: (Applicant's Description) Although subclinical cardiac abnormalities are common and often progressive in long-term survivors of childhood cancer who have been treated with anthracycline chemotherapy or mediastinal irradiation, a comprehensive assessment of risk factor for premature symptomatic cardiovascular disease has never been performed. The relationship between emerging late effects of treatment (lipid abnormalities, obesity, and cardiomyopathy) warrants further study. In this application, the investigators will study and identify a comprehensive cardiac risk factor profile on all eligible long-term survivors of childhood cancer within the catchment area of upstate New York. The primary hypothesis is that these patients will have more risk factors for subsequent symptomatic cardiovascular disease than two control populations that will be studied. The first will be matched siblings of treated patients, and the second will be long-term survivors of childhood cancer who have not been treated with therapy known to be cardiotoxic. The investigators will be able to determine whether there are increased risk factors and whether these risk factors are related to prior oncologic therapy. The second hypothesis is that there are differences in the number of cardiac risk factors for three groups of long-term survivors: those treated with anthracyclines alone, those treated with radiation to the heart alone, and those treated with both. The applicants will specifically determine the presence of depressed left ventricular (LV) function, thin LV wall, elevated LV afterload, increased body fat, elevated blood pressure, abnormal endothelial function, and abnormal lipid profiles. These will be compared to the control populations. Other secondary risk factors will be determined. Longitudinal changes in study and control patients will be determined as well to chart the trajectory over time in risk factors in different populations. If the hypotheses are true, this should enable more rational recommendations for preventive cardiology in long-term survivors to be made and to standardize care and management for this population.
Dietary quality, caloric intake, and adiposity of childhood cancer survivors and their siblings: an analysis from the cardiac risk factors in childhood cancer survivors study.
Authors: Landy DC, Lipsitz SR, Kurtz JM, Hinkle AS, Constine LS, Adams MJ, Lipshultz SE, Miller TL
Source: Nutr Cancer, 2013;65(4), p. 547-55.
Exercise capacity in long-term survivors of pediatric cancer: an analysis from the Cardiac Risk Factors in Childhood Cancer Survivors Study.
Authors: Miller AM, Lopez-Mitnik G, Somarriba G, Lipsitz SR, Hinkle AS, Constine LS, Lipshultz SE, Miller TL
Source: Pediatr Blood Cancer, 2013 Apr;60(4), p. 663-8.
EPub date: 2012 Dec 19.
Cranial irradiation as an additional risk factor for anthracycline cardiotoxicity in childhood cancer survivors: an analysis from the cardiac risk factors in childhood cancer survivors study.
Authors: Landy DC, Miller TL, Lipsitz SR, Lopez-Mitnik G, Hinkle AS, Constine LS, Adams MJ, Lipshultz SE
Source: Pediatr Cardiol, 2013 Apr;34(4), p. 826-34.
EPub date: 2012 Oct 19.
Anthracycline associated cardiotoxicity in survivors of childhood cancer.
Authors: Lipshultz SE, Alvarez JA, Scully RE
Source: Heart, 2008 Apr;94(4), p. 525-33.
Anthracycline cardiotoxicity in long-term survivors of childhood cancer.
Authors: Scully RE, Lipshultz SE
Source: Cardiovasc Toxicol, 2007;7(2), p. 122-8.
Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management.
Authors: Barry E, Alvarez JA, Scully RE, Miller TL, Lipshultz SE
Source: Expert Opin Pharmacother, 2007 Jun;8(8), p. 1039-58.
Long-term effects of treatments for childhood cancers.
Authors: Alvarez JA, Scully RE, Miller TL, Armstrong FD, Constine LS, Friedman DL, Lipshultz SE
Source: Curr Opin Pediatr, 2007 Feb;19(1), p. 23-31.
Incidence, causes, and outcomes of dilated cardiomyopathy in children.
Authors: Towbin JA, Lowe AM, Colan SD, Sleeper LA, Orav EJ, Clunie S, Messere J, Cox GF, Lurie PR, Hsu D, Canter C, Wilkinson JD, Lipshultz SE
Source: JAMA, 2006 Oct 18;296(15), p. 1867-76.
Factors associated with establishing a causal diagnosis for children with cardiomyopathy.
Authors: Cox GF, Sleeper LA, Lowe AM, Towbin JA, Colan SD, Orav EJ, Lurie PR, Messere JE, Wilkinson JD, Lipshultz SE
Source: Pediatrics, 2006 Oct;118(4), p. 1519-31.
Frequency of clinically unsuspected myocardial injury at a children's hospital.
Authors: Lipshultz SE, Wong JC, Lipsitz SR, Simbre VC 2nd, Zareba KM, Galpechian V, Rifai N
Source: Am Heart J, 2006 Apr;151(4), p. 916-22.
Impact of HIV and highly active antiretroviral therapy on leukocyte adhesion molecules, arterial inflammation, dyslipidemia, and atherosclerosis.
Authors: Fisher SD, Miller TL, Lipshultz SE
Source: Atherosclerosis, 2006 Mar;185(1), p. 1-11.
EPub date: 2005 Nov 16.
Cardiac changes associated with growth hormone therapy among children treated with anthracyclines.
Authors: Lipshultz SE, Vlach SA, Lipsitz SR, Sallan SE, Schwartz ML, Colan SD
Source: Pediatrics, 2005 Jun;115(6), p. 1613-22.
Chronic progressive cardiac dysfunction years after doxorubicin therapy for childhood acute lymphoblastic leukemia.
Authors: Lipshultz SE, Lipsitz SR, Sallan SE, Dalton VM, Mone SM, Gelber RD, Colan SD
Source: J Clin Oncol, 2005 Apr 20;23(12), p. 2629-36.
Cardiovascular status in long-term survivors of Hodgkin's disease treated with chest radiotherapy.
Authors: Adams MJ, Lipsitz SR, Colan SD, Tarbell NJ, Treves ST, Diller L, Greenbaum N, Mauch P, Lipshultz SE
Source: J Clin Oncol, 2004 Aug 1;22(15), p. 3139-48.
Cardiovascular risk factors, monitoring, and therapy for HIV-infected patients.
Authors: Lipshultz SE, Fisher SD, Lai WW, Miller TL
Source: AIDS, 2003 Apr;17 Suppl 1, p. S96-122.
The incidence of pediatric cardiomyopathy in two regions of the United States.
Authors: Lipshultz SE, Sleeper LA, Towbin JA, Lowe AM, Orav EJ, Cox GF, Lurie PR, McCoy KL, McDonald MA, Messere JE, Colan SD
Source: N Engl J Med, 2003 Apr 24;348(17), p. 1647-55.
Cardiovascular monitoring and therapy for HIV-infected patients.
Authors: Lipshultz SE, Fisher SD, Lai WW, Miller TL
Source: Ann N Y Acad Sci, 2001 Nov;946, p. 236-73.
Epidemiology of anthracycline cardiotoxicity in children and adults.
Authors: Grenier MA, Lipshultz SE
Source: Semin Oncol, 1998 Aug;25(4 Suppl 10), p. 72-85.