Key result
Early deterioration of the GLS×LVtw index was the best predictor of later anthracycline-induced cardiotoxicity, followed by GLS and LV apical rotation.
Why the study?
Does the GLS×LVtw index predict future anthracycline-induced cardiomyopathy in patients receiving anthracycline treatment?
Cohort (n=74)
Does the GLS×LVtw index predict future anthracycline-induced cardiomyopathy in patients receiving anthracycline treatment?
The combined echocardiographic index of global longitudinal strain and left ventricular twist (GLS×LVtw) is a highly accurate early predictor of anthracycline-induced cardiotoxicity, outperforming individual parameters.
Answers are grounded in this paper and cite their sources.
Strain imaging may aid earlier anthracycline cardiotoxicity detection; hypothesis-generating and requires prospective validation before practice change.
Anthracyclines are important anticancer drugs, but their use is limited by cardiotoxicity. Left ventricular ejection fraction (LVEF) is often inadequate to detect myocardial disease induced by chemotherapy. Tissue Doppler and bidimensional-strain imaging could detect LV myocardial dysfunction earlier than LVEF. In drug-induced cardiotoxicity, torsional and longitudinal LV deformations [LV twist (LVtw), radial strain (GRS), global longitudinal strain (GLS)] are damaged. We assessed whether a new index, GLS×LVtw, could predict future anthracycline-induced cardiomyopathy. Echocardiography, troponin, and natriuretic peptide determination were prospectively performed in 74 patients before and after 6, 12, 24, and 52 weeks of anthracycline treatment. These patients were treated for breast cancer, Hodgkin's or non-Hodgkin's lymphoma, acute lymphoblastic or myeloblastic leukaemia, or osteosarcoma. At 6 weeks after initiation of chemotherapy, isovolumic relaxation time, systolic mitral annular velocity, LVGLS, LVGRS, LV apical rotation, LVtw, and GLS×LVtw deteriorated, and troponin levels became elevated (all p < 0.05 by ANOVA) before LVEF decreased. The receiver operating characteristic curves identified early deterioration of GLS×LVtw as the best predictor of later cardiotoxicity (area under curve = 0.93), followed by GLS (0.84) and LV apical rotation (0.81) deterioration. In conclusion, early change in the GLS×LVtw index seems to be a good predictor of future development of anthracycline-induced cardiotoxicity.
No takes yet. Share an insight, caveat, or question.
Mornoş et al. (2013) conducted a cohort in Cancer patients receiving anthracyclines (n=74). GLS×LVtw index was evaluated on future anthracycline-induced cardiotoxicity (AUC 0.93). Early deterioration of the GLS×LVtw index was the best predictor of later anthracycline-induced cardiotoxicity, followed by GLS and LV apical rotation.
Synapse has enriched 10 related papers. Consider them for comparative context: