2D speckle tracking echocardiography detected anthracycline-induced left ventricular insufficiency earlier than conventional echocardiography, showing significant changes after 2 cycles (P<0.01).
Observational (n=33)
Does two-dimensional speckle tracking echocardiography improve the early detection of left ventricular insufficiency in breast cancer patients receiving anthracyclines compared to conventional echocardiography?
Two-dimensional speckle tracking echocardiography provides higher sensitivity for the early detection of anthracycline-induced left ventricular dysfunction compared to traditional echocardiography.
valor p: p=<0.01
Anthracyclines have been one of the most important therapeutic methods in breast cancer therapy for decades. However, serious long-term toxicities, especially cardiotoxicity limits the continuous usage of anthracyclines, hence affects long term prognosis. Early detection of myocardial dysfunction during treatment is critical but challenging. Two-dimensional speckle tracking echocardiography (2D-STE) is a non-Doppler technique that can assess deformation and strain by tracking displacement of acoustic markers in the myocardium. This study aims to compare the sensitivity and precision between 2D-STE and traditional echocardiography on monitoring the left ventricular function in patients with breast cancer after anthracyclines therapy, which is the key indicator for evaluating myocardial changes. Thirty-three patients with breast cancer were recruited from February 2019 to December 2019. All patients were treated with 4 cycles anthracycline. 2D-STE and conventional echocardiography were performed on each patient. Two-dimensional echocardiographic examination was used to collect data interventricular septum diameter (IVSD), end-diastolic left ventricular posterior wall diameter (LVPWD), left ventricular end-diastolic diameter (LVEDD) and left ventricular systole on the parasternal left ventricular long axis view. The final diameter (left ventricular end-systolic diameter LVESD) and the left ventricular short axis shortening rate (LVFS) was measured by M-type. The two-plane Simpson's method was used to measure left ventricular end-diastolic volume (LVEDV) and end-systolic volume (left ventricular end-systolic volume LVESV) to obtain left ventricular ejection fraction (LVEF). Two-dimensional speckle tracking imaging technical indicator includes left ventricular global longitudinal strain (LVGLS), subendocardial myocardial longitudinal strain (LVGLS-Endo) and epicardial myocardial longitudinal strain (LVGLS-Epi). The correlation between 2-dimensional speckle tracking imaging and conventional ultrasound parameters were analyzed. Compared with baseline (T0), the systolic function parameter LVEF was significantly changed after four cycle chemotherapy (T4) (P .05). Meanwhile, the two-dimensional strain parameters LVGLS, LVGLS-Endo, and LVGLS-Epi were statistically significant after T2 and T4 cycle chemotherapy (P < .01).The two-dimensional strain parameter GLS has higher accuracy and sensitivity for monitoring left ventricular insufficiency caused by anthracycline therapy when compared with traditional echocardiography.
Chen et al. (Fri,) conducted a observational in Breast cancer patients undergoing anthracycline therapy (n=33). Two-dimensional speckle tracking echocardiography (2D-STE) vs. Conventional echocardiography was evaluated on Changes in left ventricular function parameters (LVGLS, LVGLS-Endo, LVGLS-Epi vs conventional parameters) (p=<0.01). 2D speckle tracking echocardiography detected anthracycline-induced left ventricular insufficiency earlier than conventional echocardiography, showing significant changes after 2 cycles (P<0.01).