Speckle tracking echocardiography predicts early subclinical anthracycline cardiotoxicity in patients with breast cancer

Tang, Qi; Jiang, Yan; Xu, Yali; Xia, Hongmei

doi:10.1002/jcu.22434

Cited by 25 publications

(19 citation statements)

References 41 publications

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“…A 15% change from the initial value is considered to be clinically significant (4). Changes in LV strain after RT have been described earlier, but their prognostic impact is unclear (8,9). In our patients, the initial GLS change persisted in the three-year follow-up, which may implicate permanent damage.…”

Section: Changes In Apical Strain In the Follow-up According To Brementioning

confidence: 48%

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

et al. 2019

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Background/Aim: Chest radiotherapy (RT) doubles late cardiac mortality. This study aimed to evaluate the evolution of cardiac changes in speckle tracking echocardiography during a three-year follow-up. Materials and Methods: This prospective study included 81 chemotherapy-naïve early-stage breast cancer patients who were evaluated at baseline, immediately after RT and three years after RT. Sixty-one patients had left-sided (LSBC) and 20 right-sided breast cancer (RSBC). Results: Global longitudinal strain (GLS) declined from baseline-18.0±3.3% to-17.0±3.0% (p=0.015) at the three-year follow-up examination. A decline over 15% (GLS15) was observed in 19 (27%) patients. GLS15 was independently associated with aromatase inhibitor use (β=-1.977, p=0.001). In regional analysis, patients with LSBC had apical strain decline by 3.2±5.5% (p<0.001) and patients with RSBC showed basal rotation decline by 1.8˚ (-0.2˚, 3.8˚) (p=0.030). Conclusion: Even contemporary RT induced progressive global and regional decline in speckle tracking analysis. The regional changes complied with RT fields. Radiotherapy (RT) is an integral part of the treatment in half of cancer patients (1). Over 80% of early-stage breast cancer patients receive adjuvant RT, which reduces the local recurrence risk by half and, the late breast cancer-related mortality by a fifth. The overall survival of early-stage breast cancer patients at 5 years is 91% in Finland (www.cancerregistry.fi). However, RT induces adverse effects in healthy tissue, which may lead to late dysfunction in adjacent organs. The heart is an important organ at risk, especially in left-sided breast cancer (LSBC). Breast cancer RT increases cardiac mortality and morbidity almost twofold in long-term cohorts collected from patients treated with older RT techniques (2, 3). The modern RT treatment protocols have reduced cardiac radiation exposure. However, the clinical impact of the reduced cardiac dose will not be revealed until long-term data are available. In the meantime, early and mid-term cardiac changes are valuable in predicting later sequelae and to reveal the mechanism and time-course of RT-induced heart disease (RIDH). RIHD can manifest as coronary artery disease, valvular lesions, heart failure, pericardial changes or conduction abnormalities. These changes occur usually several years or decades after RT treatment (2-4). The early subclinical RTinduced cardiac changes precede the late manifestations. Perfusion defects and changes in strain and strain rate corresponding to the RT fields have been detected 0-6 months after RT with myocardial perfusion imaging and with echocardiography (5-7). After chemotherapy, an early change in global longitudinal strain (GLS) predicts later decline in left ventricular ejection fraction (LVEF), but the knowledge of post-RT strain evolution is sparse (8, 9). The aim of our study was to explore the evolution of early RT-induced changes in speckle tracking echocardiography (STE) in early-stage breast cancer patients within the first three years after ...

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Section: Changes In Apical Strain In the Follow-up According To Brementioning

confidence: 48%

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

et al. 2019

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“…Критериями кардиотоксичности служило снижение ФВ ЛЖ менее, чем на 53 %, либо снижение ОБЗОРЫ § показателя глобальной продольной деформации на 10 % от исходных значений. В исследовании было показано, что снижение глобальной продольной деформации на 13,8 % от исходных значений было самым сильным индикатором развития кардиотоксичности (чувствительность -93 %; специ фичность -84 %) [36].…”

Section: Discussionunclassified

Possibilities of modern echocardiographic technologies in the early diagnosis of the cardiotoxic effect of chemotherapy drugs anthracycline series in cancer patients

Nedogoda

Конради

Звартау

et al. 2017

CARDIO

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Возможности современных эхокардиографических технологий в ранней диагностике кардиотоксического действия химиотерапевтических препаратов антрациклинового ряда у онкологических больных Ключевые слова: химиотерапия, антрациклиновая кардиотоксичность, спекл-трекинг, продольная глобальная деформация ЛЖ, триметазидин

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“…76,79,103 An 8% reduction defines patients with low risk of subclinical damage, but between 8-15% does not rule out patients at risk. [126][127][128][129] In addition, changes in circumferential deformation have been associated with a higher probability of toxicity in women who received treatment for BC (RR of 31% for every 1% reduction compared to baseline). 130 • Echocardiogram in the follow-up.…”

Section: Using Imaging Techniques To Diagnose Cardiac Damagementioning

confidence: 99%

“…132 Since the endocardium is the most vulnerable structure to the toxic effects of chemotherapy, assessment of myocardial deformation with GLS surveillance may become the most sensitive strategy for early detection of CT. 79,126,127 It has been reported that the reduction of GLS>15% from baseline at three months, predicts LVEF drop with 79% sensitivity and 82% specificity. 129…”

Section: Using Imaging Techniques To Diagnose Cardiac Damagementioning

confidence: 99%

Abordaje de la enfermedad cardiovascular en mujeres con cáncer de mama. Posición de la Asociación Nacional de Cardiólogos de México (ANCAM)

Figueiras-Graillet¹,

García-Jiménez²,

Rosas-Munive³

et al. 2020

Cardiovasc Metab Sci

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La enfermedad cardiovascular es la primera causa de muerte en la mujer que sobrevive al cáncer de mama. La magnitud de los efectos cardiotóxicos depende no sólo del tratamiento antineoplásico, sino de la susceptibilidad individual, que está determinada por la enfermedad cardiovascular preexistente y los factores de riesgo concurrentes, así como de las intervenciones en la prevención, identificación y tratamiento oportuno de la cardiotoxicidad. La Asociación Nacional de Cardiólogos de México, inmersa en esta realidad, comparte en el presente documento un abordaje que explica la interacción de las dos entidades desde la perspectiva de la mujer de alto riesgo y resume las estrategias de detección y cardioprotección actuales.

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Speckle tracking echocardiography predicts early subclinical anthracycline cardiotoxicity in patients with breast cancer

Cited by 25 publications

References 41 publications

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

Possibilities of modern echocardiographic technologies in the early diagnosis of the cardiotoxic effect of chemotherapy drugs anthracycline series in cancer patients

Abordaje de la enfermedad cardiovascular en mujeres con cáncer de mama. Posición de la Asociación Nacional de Cardiólogos de México (ANCAM)

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