The goal of this prospective interventional study is to improve the detection of subclinical chronic Cancer Therapy-Related Cardiovascular Toxicity (CTRCT) and evaluate the added value of advanced cardioechography, ergospirometry, and specific biomarkers in pediatric cancer survivors (aged 2 to 25) who received potentially cardiotoxic treatments (chemotherapy/thoracic radiotherapy). The main questions it aims to answer are:
* Can advanced echocardiography (including strain and myocardial work), ECG, and ergospirometry effectively diagnose earlier subclinical cardiac impairment in this population? * What is the prevalence of cardiovascular risk factors (including physical activity levels and biological markers like proBNP/troponins) * Can new genetic or biological markers be identified to help optimizing the detection of CTRCT?
At time of follow-up, if they agree, participants will:
* Complete validated questionnaires regarding quality of life, physical activity, and sedentary behavior. * Undergo a cardiopulmonary exercise test (ergospirometry) for those aged over 8 years. * Wear an accelerometer (ActiGraph GT3X) for 7 consecutive days to monitor physical activity. * Provide an additional blood sample during routine follow-up for the creation of a biobank dedicated to analyzing markers of senescence, fibrosis, apoptosis, and genetic polymorphisms.
History of chemotherapy and/or radiotherapy for an oncological condition or bone marrow transplantation (hematologic disease) after 01/01/2016.
Age < 18 years at the time of treatment.
Cancer remission for more than one year.
Voluntary participation following comprehensive informed consent.
Active disease recurrence or relapse.
Current administration of antineoplastic therapy.
Withdrawal of consent or refusal to participate by the patient or their legal representatives.
Single group
Ergospirometry
Diagnostic testCompletion of validated, age-appropriate quality of life scales and physical activity assessment forms. Patients over 8 years of age will perform a standardized cardiopulmonary exercise test (CPET / ergospirometry) on a treadmill. Seven-day continuous monitoring using a wearable accelerometer. Collection of a 10 mL blood sample (one EDTA tube and one serum-clotting tube), to be centrifuged and stored at -80°C in the CHU de Liège "BHUL" biobank.
EKG anomaly
Presence of arrhythmia, prolonged QTc interval, or conduction disorders.
Echocardiography anomaly: systolic dysfunction
Systolic dysfunction: LVEF \< 55% or a relative decrease of \>15%.
Echocardiography anomaly: diastolic dysfunction
Based on standardized pediatric values : * E/A ratioaverage * E/e' \> 14 * e' velocities * LA volume index \> 32 mL/m².
Echocardiography anomaly: Significant alteration in myocardial deformation
GLS decrease \> 15%
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Centre Hospitalier Universitaire de Liege
Lead sponsor
Centre Hospitalier Régional de la Citadelle
Collaborator
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