Use of speckle strain to assess left ventricular responses to cardiotoxic chemotherapy and cardioprotection

Negishi, Kazuaki; Negishi, Tomoko; Haluska, Brian; Hare, James L.; Plana, Juan Carlos; Marwick, Thomas H.

doi:10.1093/ehjci/jet159

Cited by 214 publications

(147 citation statements)

References 31 publications

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“…Future studies with larger number of patients may be able to evaluate a more accurate time course of the cardiac dysfunction and to detect it earlier in patients with childhood cancer after anthracycline treatment. These findings have important clinical implications and may allow for early therapeutic intervention, such as β-blockers, 12 for subclinical LV dysfunction to prevent LV dysfunction, and angiotensinconverting enzyme inhibitors 35 and angiotensin-receptor blockers to reduce wall stress and potentially improve the impairment of myocardial deformation. Furthermore, this parameter could allow better evaluation of the therapeutic effects of these medications.…”

Section: Discussionmentioning

confidence: 95%

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Childhood Cancer After Anthracycline Treatment Using Layer-Specific Strain Analysis

Yazaki

Takahashi

Shigemitsu

et al. 2018

Circ J

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Section: Discussionmentioning

confidence: 95%

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Childhood Cancer After Anthracycline Treatment Using Layer-Specific Strain Analysis

Yazaki

Takahashi

Shigemitsu

et al. 2018

Circ J

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“…Previous work has demonstrated that in patients receiving cardiotoxic chemotherapy, β-blocker administration reversed worsening of longitudinal strain. 46 Recently, extracorporeal removal of sFlt1 has been shown to improve pregnancy outcomes in women with preeclampsia. 47,48 Whether such therapies have a protective effect on the heart remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Circulating Antiangiogenic Factors and Myocardial Dysfunction in Hypertensive Disorders of Pregnancy

et al. 2016

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H ypertensive disorders of pregnancy (HDP) affect 5% to 10% of pregnant women, 1 are the most common medical complication of pregnancy in developed countries, 2 and are a leading cause of maternal and fetal death worldwide. 3 HDP include preeclampsia, gestational hypertension, chronic hypertension, and superimposed preeclampsia. Preeclampsia targets the vascular endothelium causing widespread maternal vascular endothelial dysfunction. Antiangiogenic proteins have been implicated as being pathogenic in the development of the observed vascular endothelial dysfunction. 4Overexpression of soluble fms-like tyrosine kinase-1 (sFlt1), an endogenous vascular endothelial growth factor inhibitor, is associated with preeclampsia-like phenotypes in a rodent model and symptoms diminish with the addition of vascular endothelial growth factor or placental growth factor. [5][6][7] Multiple human clinical studies have established that levels of the sFlt1 and soluble endoglin (sEng) increase in the circulation of pregnant women with preeclampsia. 4,6,[8][9][10] sFlt1 and sEng levels are elevated weeks before the clinical onset of preeclampsia, and the degree of elevation correlates with adverse maternal and fetal outcomes. 8,[11][12][13][14][15][16] Few adverse outcomes occur in the absence of angiogenic factor abnormalities. 17,18 Although previous studies have detected changes in myocardial function in HDP, 19,20 a direct association between preeclampsia biomarkers, including sFlt1 and sEng, has not been described. In other abnormal cardiovascular states such as congestive heart failure, increased circulating levels of antiangiogenic proteins have been associated with development of endothelial vascular dysfunction, myocardial dysfunction, and adverse cardiovascular outcomes. 21Women with HDP have abnormalities in both systolic and diastolic cardiac function that seem before clinical symptoms.19,22 Despite preservation of left ventricular ejection fraction (LVEF), 23 longitudinal muscle fiber shortening is decreased, suggesting the presence of subclinical left ventricular systolic dysfunction. 20 This finding suggests a Abstract-Hypertensive disorders of pregnancy (HDP) are associated with subclinical changes in cardiac function. Although the mechanism underlying this finding is unknown, elevated levels of soluble antiangiogenic proteins such as soluble fms-like tyrosine kinase-1 (sFlt1) and soluble endoglin (sEng) are associated with myocardial dysfunction and may play a role. We hypothesized that these antiangiogenic proteins may contribute to the development of cardiac dysfunction in HDP. We prospectively studied 207 pregnant women with HDP and nonhypertensive controls and evaluated whether changes in global longitudinal strain (GLS) observed on echocardiography is specific for HDP and whether these changes correlate with HDP biomarkers, sFlt1 and sEng. A total of 62 (30%) patients were diagnosed with preeclampsia (group A), 105 (51%) did not have an HDP (group B), and 40 (19%) were diagnosed with chronic or gestational hype...

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“…Obecnie nie ma dowodów, aby podejmować decyzje o zastosowaniu leczenia kardioprotekcyjnego, jeżeli stwierdzi się wczesne cechy subklinicznej dysfunkcji mięśnia sercowego, dokonując pomiarów GLS podczas kontrolnych badań echokardiograficznych [85,90,250]. Ocena GLS może być bardziej czułym narzędziem wykrywania wczesnej kardiotoksyczności, ale na podstawie obecnie dostępnych danych nie należy odstawiać, czasowo przerywać lub zmniejszać dawki leczenia onkologicznego na podstawie samego nowo wykrytego zmniejszenia GLS.…”

Section: Pacjenci Z Bezobjawowym Zmniejszeniem Globalnego Skurczowegounclassified

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

Zamorano¹,

Lancellotti²,

Muñoz³

et al. 2016

Kardiol Pol

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Use of speckle strain to assess left ventricular responses to cardiotoxic chemotherapy and cardioprotection

Abstract: GLS is an effective parameter for identifying systolic dysfunction (which appears worst with combined anthracycline and trastuzumab therapy) and responds to cardioprotection in patients administered beta-blockers.

Cited by 214 publications

References 31 publications

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Childhood Cancer After Anthracycline Treatment Using Layer-Specific Strain Analysis

In-Depth Insight Into the Mechanisms of Cardiac Dysfunction in Patients With Childhood Cancer After Anthracycline Treatment Using Layer-Specific Strain Analysis

Circulating Antiangiogenic Factors and Myocardial Dysfunction in Hypertensive Disorders of Pregnancy

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

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