Assessment of biventricular systolic strain derived from the two-dimensional and three-dimensional speckle tracking echocardiography in lymphoma patients after anthracycline therapy

Abstract

The aim of this study was to investigate the usefulness of three-dimensional (3D) speckle tracking echocardiography (STE) for assessment of both left and right ventricular systolic function in patients with lymphoma after anthracycline chemotherapy, compared with two-dimensional (2D) STE. Totally eighty-nine patients undergoing anthracycline containing chemotherapy were studied. Echocardiographic assessment included 2D and 3D left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS) and right ventricular (RV) GLS. All the parameters were analyzed at baseline, after the completion of four cycles and at the end of the regimen respectively. The area under the receiver operating characteristic curve was calculated to determine the capability of various echocardiographic parameters to discriminate between before and after chemotherapy. Compared with those at baseline, the 3D GLS and GCS of LV and GLS of RV decreased significantly after four cycles of the therapy (all p < 0.01). At the end of the treatment, 2D GLS and GCS of LV deteriorated markedly (both p < 0.05). The area under the curve for GLS, GCS of LV and GLS of RV derived by 3D were 0.81, 0.66 and 0.78, respectively. The cutoff value with -20.4% of LV GLS by 3D had sensitivity of 81% and specificity of 66% for differentiating patients after therapy from baselines. The cutoff value with -21.9% of RV GLS by 3D had sensitivity of 71% and specificity of 74% fordifferentiating patients after therapy from baselines. The data from this study demonstrated that both 2D and 3D STE can be conducted to evaluate the slight myocardial damage for lymphoma patients after anthracycline chemotherapy. 3D STE could examine subclinical biventricular dysfunction in earlier point than 2D STE.

Use of echocardiography to monitor myocardial damage during anthracycline chemotherapy

“…A number of foreign research results show that LVEF values were not significantly reduced when the average cumulative dose of anthracycline was up to 350-700 mg/m 2. [16][17][18] In our study, LVEF was significantly reduced when the cumulative dose of anthracycline was at 320 mg/m 2 . Previous studies on the sensitivity of GLS in monitoring anthracycline-induced myocardial damage showed that when the average cumulative dose was 60 mg/m 2 , GLS did not decrease significantly, 19 and when the average cumulative dose was 266 mg/m 2 (200-298 mg/m 2 ), GLS decreased significantly.…”

Predictive value of left ventricular myocardial strain by four‐dimensional speckle tracking echocardiography combined with red cell distribution width in heart failure with preserved ejection fraction

“…6 It can evaluate myocardial mechanics accurately and satisfactorily. 6 Four-dimensional (4D) STE acquires a three-dimensional image of the heart and aims at real-time visualization of variation of strain in each segment of the LV employing color mapping; 6 avoids the inherent shortcomings of two-dimensional (2D) STE such as geometric structure hypothesis, time-consuming examination, and missing tracking while speckles move out of the scanning area; 7 and provides a noninvasive method to the assessment of slight damage in HFpEF comparatively simply. 8 In complete blood count analysis, red cell distribution width (RDW) has been a widely used hematological index in recent years.…”

Three‐dimensional speckle‐tracking echocardiography for evaluating myocardial motion in patients with cardiorenal syndrome

“…It was found that 25% untwist was related to oxygen uptake, which can be used as an independent predictor of aerobic exercise ability and a good indicator of cardiac diastolic function in patients with HF . 3D‐STE can also detect early left ventricular dysfunction caused by hypertrophic cardiomyopathy, essential hypertension, type 2 diabetes mellitus, and chemotherapy drugs . In addition to evaluating LV myocardial motion, 3D‐STE can also evaluate the left atrium, right atrium, and right ventricle …”

“…36 3D-STE can also detect early left ventricular dysfunction caused by hypertrophic cardiomyopathy, 37 essential hypertension, 38 type 2 diabetes mellitus, 39 and chemotherapy drugs. 40 In addition to evaluating LV myocardial motion, 3D-STE can also evaluate the left atrium, 41 right atrium, 42…”