Longitudinal rotation: a new way to detect the cardiotoxicity of anthracycline-based chemotherapy in breast cancer patients

Figures

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  Figure 1. Peak early-diastole LV wall velocities at baseline and 3 weeks and 6 months after the final cycle of chemotherapy The peak early-diastole LV wall velocity at baseline was significantly higher than at 3 weeks and 6 months after the final cycle of chemotherapy.

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  Figure 2. Bulls eye diagrams of the peak systolic strain of LV in the subendocardial, midmyocardial, and subepicardial layers at three time points (A, B, C). (A) At baseline, (B) 3 weeks after the final cycle of chemotherapy, and (C) 6 months after the final cycle of chemotherapy. Global PSLR in breast cancer patients at three separate time points (D, E, F). (D) At baseline, (E) 3 weeks after the final cycle of chemotherapy, and (F) 6 months after the final cycle of chemotherapy. PSLR: peak systolic longitudinal rotation.

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  Figure 3. Lateral wall (A) and global PSLR (B) at baseline and 3 weeks and 6 months after the final cycle of chemotherapy. The absolute value of the lateral wall PSLR was higher at baseline than at 3 weeks and 6 months after the final cycle of chemotherapy, while the absolute value of the global PSLR at baseline was lower than at 3 weeks and 6 months after the final cycle of chemotherapy.

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  Figure 4. Correlation between global PSLR and e’lat at 3 weeks after the final cycle of chemotherapy Global PSLR positively correlated with the e’lat at 3 weeks, and thus, breast cancer patients with a higher e’lat at 3 weeks after the final chemotherapy cycle may have a higher global PSLR (A). Correlations between global PSLR and e’sep, e’lat, E/e’sep, and E/e’lat at 6 months after the final cycle of chemotherapy. Global PSLR positively correlated with e’sep and e’lat and negatively correlated with E/e’sep and E/e’lat. Breast patients with a higher e’sep and e’lat, and lower E/e’sep and E/e’lat may have a higher global PSLR (B, C, D, E). ROC analysis for determining the accuracy of PSLR for identifying cardiac dysfunction in breast cancer patients. The sensitivity and specificity for a PSLR cut-off value of -2.58° at 3 weeks after the final cycle of chemotherapy were 55.8% and 72.1%, respectively, with an area under the ROC curve of 0.649 (F). At 6 months after the final cycle of chemotherapy, these values were 67.4% and 60.5% for a PSLR, cut-off value of -1.50°, with an area under the ROC curve of 0.665 (G).

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  Figure 5. Differences in peak early-diastole LV wall velocity (A) and lateral wall (B) and global PSLR (C) after epirubicin-based chemotherapy versus therarubicin-based chemotherapy at baseline and 3 weeks and 6 months after the final cycle of chemotherapy. The absolute values of the peak early-diastole LV wall velocity and the lateral wall PSLR at baseline were higher than those at 3 weeks and 6 months after the final cycle of chemotherapy, whereas the absolute value of global PSLR at baseline was lower than at 3 weeks and 6 months after the final cycle of chemotherapy in both epirubicin-based and therarubicin-based chemotherapy groups.