Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular function in patients with cancer therapy-related left ventricular dysfunction

Cherata, D.A.; Donoiu, Ionuţ; Diaconu, Rodica; Glodeanu, Adina Dorina; Cârstea, Doina; Militaru, Constantin; Istrătoaie, Octavian

doi:10.15190/d.2019.7

Cited by 17 publications

(20 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Keramida et al 13 found that the cutoff value of RV GLS percent change that identified cardiotoxicity was 14.8% with a sensitivity of 66.7%, a specificity of 70.8% and the AUC of 0.68 in breast cancer patients. Cherata et al 21 demonstrated that 17% reduction of RV FWLS had a sensitivity of 55% and a specificity of 70% with AUC of 0.75 to identify patients with CTRCD. ROC analysis in this study showed that variation of RV FWLS has better sensitivity and specialty in detection of subclinical cardiotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Xu¹,

Mao²,

Liu³

et al. 2021

IJGM

View full text Add to dashboard Cite

Objective: This study was aimed at assessing the longitudinal strain changes of RV function using three-dimensional speckle tracking echocardiography (3D STE) in breast cancer patients receiving anthracycline chemotherapy. Patients and Methods: A total of 95 women with breast cancer receiving epirubicin (360 mg/m 2) underwent 3D STE at baseline, the end of chemotherapy and 12 months after chemotherapy. 3D STE assessment included RV ejection fraction (EF), LV global longitudinal strain (GLS), RV GLS, and RV free wall longitudinal strain (RV FWLS). Meanwhile, serum hs-cTnI and NT-proBNP were measured. Chemotherapy-related cardiac dysfunction (CTRCD) was defined as an absolute decrease in 3D LVEF > 10% to a value <50%, while a percent reduction of 3D LV GLS > 15% indicated subclinical CTRCD. Results: Subclinical CTRCD occurred in 10 (10.5%) patients during follow-up. Compared to baseline, the 3D GLS of LV and GLS and FWLS of RV decreased significantly at 12months after chemotherapy (all p<0.01). Variations of 3D RV GLS and RV FWLS had a good discrimination for predicting subclinical CTRCD. The variation of 3D RV FWLS was the only independent predictor of subclinical CTRCD (OR, 1.37; 95% CI, 1.12-2.87; p = 0.028) in multivariate analysis. The cutoff value with −17.5% of 3D RV FWLS variation had a high predictive accuracy for subclinical CTRCD, with an AUC of 0.74, 80.5% sensitivity and 65.8% specificity. The association between 3D RV FWLS and the cumulative dose of anthracyclines was calculated by Spearman's test (r = −0.71, p < 0.001). Conclusion: Longitudinal strain analysis by 3D STE allows the identification of subclinical RV dysfunction when conventional indices of RV function are unaffected. 3D RV FWLS was superior to other parameters in early detection of the development of CTRCD in breast cancer patients receiving epirubicin therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Xu¹,

Mao²,

Liu³

et al. 2021

IJGM

View full text Add to dashboard Cite

show abstract

“…A recent report in patients with cancer treated with cardiotoxic treatment demonstrated concomitant abnormalities in longitudinal strain of the free RV wall in 75% of cases (n=20) with LVEF drop >10% to <53% (6 months after initiation of chemotherapy). 18 Conventional RV functional parameters (ie, tricuspid annular plane systolic excursion) were within normal ranges, suggesting that this novel RV strain parameter could be useful as early marker for (sub)clinical RV toxicity. These…”

Section: Right Ventricular (Rv) Functionmentioning

confidence: 86%

Update in imaging of cancer therapy-related cardiac toxicity in adults

et al. 2021

View full text Add to dashboard Cite

Over the past decades, prognosis of patients with cancer has strongly improved and the number of cancer survivors is rapidly growing. Despite this success, cancer treatment is associated with development of serious cardiovascular diseases including left ventricular (LV) systolic dysfunction, heart failure, valvular disease, myocardial infarction, arrhythmias or pericardial diseases. Serial non-invasive cardiac imaging is an important tool to detect early signs of cardiotoxicity, to allow for timely intervention and provide optimal circumstances for long-term prognosis. Currently, echocardiographic imaging is the method of choice for the evaluation of myocardial function during and after cancer therapy. However, 2D echocardiography may fail to detect subtle changes in myocardial function, potentially resulting in a significant delay of therapeutic intervention to impede advanced cardiac disease states with more overt systolic dysfunction. Strain imaging is a promising method for early detection of myocardial dysfunction and may predict future changes in LV ejection fraction. The use of three-dimensional echocardiography may overcome the limitations of 2D echocardiography with more precise and reproducible measurements of LV performance. Cardiac MRI is the gold standard for volumetric assessment and can also be used to perform myocardial tissue characterisation. Visualisation of oedema and fibrosis may provide insights into the degree and disease course of cardiotoxicity and underlying pathophysiological mechanisms. There is growing body of literature regarding the promising role of these advanced imaging modalities in early detection of cardiotoxicity. With this overview paper, new insights and recent results in literature regarding echocardiographic and cardiac magnetic resonance imaging of cancer therapy-related cardiac dysfunction in post-cancer therapy adults will be highlighted.

show abstract

“…Routine echocardiographic examinations were performed at the echocardiography core facility [ 12 , 13 ]. The patients were examined in the left lateral decubitus position by using the dedicated ultrasound equipment (GE-Vivid S6, Avante Health Solution, Concord, NC, USA) with a 3.5 MHz transducer.…”

Section: Methodsmentioning

confidence: 99%

Apolipoprotein E4 Is Associated with Right Ventricular Dysfunction in Dilated Cardiomyopathy—An Animal and In-Human Comparative Study

Diaconu

Schaaps

Afify

et al. 2021

IJMS

Self Cite

View full text Add to dashboard Cite

ApoE abnormality represents a well-known risk factor for cardiovascular diseases. Beyond its role in lipid metabolism, novel studies demonstrate a complex involvement of apoE in membrane homeostasis and signaling as well as in nuclear transcription. Due to the large spread of apoE isoforms in the human population, there is a need to understand the apoE’s role in pathological processes. Our study aims to dissect the involvement of apoE in heart failure. We showed that apoE-deficient rats present multiple organ damages (kidney, liver, lung and spleen) besides the known predisposition for obesity and affected lipid metabolism (two-fold increase in tissular damages in liver and one-fold increase in kidney, lung and spleen). Heart tissue also showed significant morphological changes in apoE−/− rats, mostly after a high-fat diet. Interestingly, the right ventricle of apoE−/− rats fed a high-fat diet showed more damage and affected collagen content (~60% less total collagen content and double increase in collagen1/collagen3 ratio) compared with the left ventricle (no significant differences in total collagen content or collagen1/collagen3 ratio). In patients, we were able to find a correlation between the presence of ε4 allele and cardiomyopathy (χ2 = 10.244; p = 0.001), but also with right ventricle dysfunction with decreased TAPSE (15.3 ± 2.63 mm in ε4-allele-presenting patients vs. 19.8 ± 3.58 mm if the ε4 allele is absent, p < 0.0001*) and increased in systolic pulmonary artery pressure (50.44 ± 16.47 mmHg in ε4-allele-presenting patients vs. 40.68 ± 15.94 mmHg if the ε4 allele is absent, p = 0.0019). Our results confirm that the presence of the ε4 allele is a lipid-metabolism-independent risk factor for heart failure. Moreover, we show for the first time that the presence of the ε4 allele is associated with right ventricle dysfunction, implying different regulatory mechanisms of fibroblasts and the extracellular matrix in both ventricles. This is essential to be considered and thoroughly investigated before the design of therapeutical strategies for patients with heart failure.

show abstract

Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular function in patients with cancer therapy-related left ventricular dysfunction

Cited by 17 publications

References 24 publications

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Update in imaging of cancer therapy-related cardiac toxicity in adults

Apolipoprotein E4 Is Associated with Right Ventricular Dysfunction in Dilated Cardiomyopathy—An Animal and In-Human Comparative Study

Contact Info

Product

Resources

About