Early Detection of Myocardial Dysfunction by Two‐Dimensional Speckle Tracking Echocardiography and Myocardial Work in Patients With Gastroenteropancreatic Neuroendocrine Neoplasms

Aims We aimed to evaluate the myocardial dyssynchrony in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP‐NENs) by two‐dimensional (2D) speckle tracking echocardiography (STE) and myocardial work (MW). Methods This cross‐sectional study included 40 patients with GEP‐NENs (45.00% men; mean age, 51.48 ± 15.22 years) and 24 age‐ and gender‐matched healthy subjects (58.33% men; mean age, 46.17 ± 11.12 years) who underwent standard echocardiography. Left ventricular (LV) and right ventricular (RV) strain measurements were assessed by 2D‐STE. Post‐systolic index (PSI) was calculated as [(post‐systolic peak longitudinal strain—end‐systolic strain)/end‐systolic strain] × 100%. LV mechanical dispersion (MD) was measured as the standard deviation of time to peak negative strain (TTP). MW indices were measured based on pressure‐strain loop (PSL) analysis. The cases were grouped based on treatment therapy. Results Compared with healthy controls, patients with GEP‐NENs had impaired global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global work efficiency (GWE), RV global strain (RV‐GS) and RV free wall strain (RV‐FWS) ( p < 0.05). Increased PSI max , MD, and global wasted work (GWW) were also observed in patients with GEP‐NENs ( p < 0.05). GLS was independently associated with male gender ( β = 0.443, p = 0.003) and hypertension ( β = −0.418, p = 0.005). MD was positively correlated with the treatment of surgery ( β = 0.333, p = 0.036). PSI max was positively correlated with the duration of disease ( β = 0.517, p = 0.001). GWI was positively correlated with the treatment of targeted therapy ( β = −0.355, p = 0.025). Conclusion Assessment of 2D‐STE and PSL analysis provides novel information to early detect LV and RV subclinical mechanical dyssynchrony in patients with GEP‐NENs.