Two‐dimensional speckle‐tracking strain detects subclinical cardiotoxicity in older patients treated for acute myeloid leukemia

Abstract

Background: Patients with acute myeloid leukemia (AML) are surviving longer. There are no data on changes in myocardial mechanics from standard of care low-dose anthracycline-based induction chemotherapy in older patients with AML. The aim of this study was to demonstrate the potential utility of strain imaging in detecting early changes in left ventricular function in this patient population after induction chemotherapy. Methods: Thirty two patients enrolled in the ECOG-ACRIN E2906 study (cytarabine and daunorubicin vs clofarabine [Genzyme/Sanofi]) from 2011 to 2014 were evaluated retrospectively. Two-dimensional transthoracic echocardiography (TTE) imaging with Doppler and two-dimensional speckle-tracking echocardiography (2DSTE) using EchoInsight software (Epsilon imaging) were performed before and after induction chemotherapy.Results: Eighteen patients received cytarabine and daunorubicin (7 + 3) and 14 received clofarabine. The clofarabine group was older than the 7 + 3 cohort (67.8 ± 4.0 vs 63.7 ± 3.8, P = .007). There were no other significant differences in cardiac risk factors between groups. The 7 + 3 group had a decrease in average peak systolic global longitudinal (−19.1 ± 2.8 to −17.2 ± 3.0, P = .01) and circumferential strain (−29.4 ± 6.3 to −23.9 ± 4.3, P = .011). These changes were not demonstrated in the clofarabine group and were not associated with a decline in left ventricular ejection fraction (LVEF). Conclusions:In older AML patients, standard cytarabine and daunorubicin chemotherapy causes early changes in global longitudinal and circumferential strain not seen with clofarabine therapy. These findings demonstrate subclinical left ventricular

Hafif Şiddette COVID-19'un Sol Ventrikül Fonksiyonları Üzerindeki Uzun Dönem Etkileri

“…Studies showed that left ventricular systolic function, which appears to be normal with traditional echocardiographic methods, can be found to have deteriorated in speckle tracking echocardiographic (STE) imaging. 4 Echocardiographic imaging techniques enable a more quantitative evaluation of complex ventricular movements. 5 Among these imaging techniques, speckle tracking is an operator and angle-independent method for evaluating regional and global wall movements and is more sensitive in detecting subclinical right and left ventricular dysfunction.…”

Short Term Effects of Mild Severity COVID-19 on Left Ventricular Functions

“…Previous reports have revealed myocardial damage in 20-40% of COVID-19 cases hospitalized due to cardiac chest pain, fulminant heart failure, cardiac arrhythmias and cardiac arrest [3] Conventional echocardiographic assessment may sometimes be insu cient for evaluation of global ventricular systolic function. Studies showed that left ventricular systolic function which appears to be normal with traditional echocardiographic methods, can be found to be deteriorated in speckle tracking echocardiographic (STE) imaging [4]. Echocardiographic imaging techniques enable more quantitative evaluation of complex ventricular movements [5].…”