Evaluation of left ventricular transmural mechanics after anthracycline chemotherapy in patients with breast cancer by speckle tracking imaging
10.3760/cma.j.issn.1004-4477.2015.12.005
- VernacularTitle:斑点追踪技术评价蒽环类药物对乳腺癌患者左心室跨壁力学的影响
- Author:
Jiping XUE
;
Lili SU
;
Chunsong KANG
;
Zhifen WANG
;
Shuai LI
;
Hong LYU
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Breast neoplasms;
Anthracyclines;
Transmural myocardial strain gradient;
Two-dimensional speckle tracking imaging
- From:
Chinese Journal of Ultrasonography
2015;(12):1033-1038
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the left ventricular transmural mechanics changes of breast cancer patients between before and after anthracycline chemotherapy by two-dimensional speckle tracking imaging (2D-STI),and to predict early cardiotoxicity caused by anthracycline.Methods Forty-six breast cancer patients with postoperative anthracycline-based chemotherapy were recruited.Echocardiography were performed on all subjects before and at 1 ,3 and 6 anthracycline-based chemotherapeutic cycle.Global longitudinal strain(GLS),endocardial longitudinal strain(LS-endo),epicardial longitudinal strain(LS-epi), global radial strain (GRS),endocardial radial strain (RS-endo ),epicardial radial strain (RS-epi ),global circumferential strain (GCS),endocardial circumferential strain (CS-endo)and epicardial circumferential strain(CS-epi) were assessed by 2D-STI and transmural myocardial strain gradient-longitudinal strain (TMSG-LS),transmural myocardial strain gradient-radial strain(TMSG-RS),transmural myocardial strain gradient-circumferential strain(TMSG-CS)were calculated.Conventional echocardiographic parameters and strain-related parameters before and after chemotherapy were compared. The receiver operating characteristics(ROC)curve was performed to determine sensitivity and specifity of strain parameters for prediction value of cardiotoxicity induced by anthracycline chemotherapy.Results ①After the sixth cycle of anthracycline chemotherapy,9 patients (16.4%)had developed anthracycline-induced cardiotoxicity,and 37 patients (80.4%)did not meet the criteria for cardiotoxicity.② There were no significant differences in conventional echocardiography parameters between before and after chemotherapy (P > 0.05 ).Left ventricular ejection fraction (LVEF),fractional shortening (FS)and E/A significantly decreased,but E/e significantly increased after six cycles of chemotherapy (P < 0.05 ).③ When comparison with baseline cases,GLS,LS-endo,LS-epi,TMSG- LS,TMSG-RS decreased after 3,6 cycles of chemotherapy,GRS, RS-endo and RS-epi decreased after six cycles of chemotherapy,the difference was statistically significant (P <0.05 ).④ ROC curve results showed the value of TMSG-LS,LS-endo,GLS and LS-epi after three cycles of chemotherapy to detect of anthracycline-induced cardiotoxicity,the areas under the curve were TMSG-LS> LS-endo> GLS> LS-epi.Conclusions After three cycles of chemotherapy,the decreases of TMSG-LS,LS-endo,GLS and LS-epi preceded the change of LVEF and other strain parameters,TMSG-LS and LS-endo can accurately and early detect anthracycline chemotherapy-induced cardiotoxicity.
