Subclinical Systolic Dysfunction during Chemotherapy for Breast Cancer

Abstract

Although most chemotherapy agents have adverse side effects, the most feared, due to its morbidity and mortality, is cardiotoxicity. Its main etiological agents are anthracyclines and trastuzumab, both of which are widely used in breast cancer treatment. [1][2][3] Several methods have been proposed to diagnose and assess cardiotoxicity secondary to cancer treatment. Currently, determining left ventricular ejection fraction (LVEF) by echocardiography has been recommended. [4][5][6][7][8][9] However, studies have shown that LVEF, despite being a robust predictor of cardiac events in general, has low sensitivity for detecting changes in LV function, 9 with a detectable drop in LVEF occurring only after damage to a large amount of myocardial tissue. 5 Large studies have found myocardial strain to be an ideal parameter of myocardial deformation for early detection of subclinical systolic dysfunction, ie, even before cardiotoxicity is diagnosed through a drop in