Key result
Anthracycline chemotherapy is linked to early asymptomatic CTRCD in ~5% of patients, best detected by LV-GLS.
Why the study?
This study aimed to assess the incidence of early cancer therapy-related cardiac dysfunction and the characteristics of left and right heart deformations during anthracycline chemotherapy.
Does left ventricular global longitudinal strain (LV-GLS) detect early anthracycline-related cardiac dysfunction better than right heart and left atrial deformations in women with breast cancer?
Cohort (n=351)
Does left ventricular global longitudinal strain (LV-GLS) detect early anthracycline-related cardiac dysfunction better than right heart and left atrial deformations in women with breast cancer?
LV-GLS is the most sensitive echocardiographic deformation indicator for detecting early anthracycline-induced cardiotoxicity, showing significant changes after just one dose.
May support LV-GLS surveillance during anthracycline therapy; leaves open outcome benefit versus LVEF monitoring.
OBJECTIVE: This study aimed to assess the incidence of early cancer therapy-related cardiac dysfunction (CTRCD) and the characteristics of left and right heart deformations during anthracycline chemotherapy. METHODS: We prospectively enrolled a cohort of 351 chemotherapy-naïve women with breast cancer and cardiovascular risk factors who were scheduled to receive anthracycline. The left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV-GLS) and right ventricular and left atrial longitudinal strains were evaluated using echocardiography at baseline, before every subsequent cycles and at 3 weeks after the final anthracycline dose. CTRCD was defined as a new LVEF reduction by ≥10 percentage points to an LVEF<50% and/or a new relative decline in GLS by >15% from the baseline value. RESULTS: Eighteen (5.1%) patients had evidence of asymptomatic CTRCD during anthracycline treatment, and 50% developed CTRCD before completing the chemotherapy regimen. In the CTRCD group, while LV-GLS decrease significantly after the first dose of anthracycline, the reduction of right ventricular free-wall longitudinal strain and left atrial reservoir strain were observed after the second dose. Other strain indices could not be used to identify early CTRCD. CONCLUSIONS: Cardiotoxicity appeared soon after the initiation of anthracycline chemotherapy. Among the left-heart and right-heart mechanics, LV-GLS remains the best deformation indicator for detecting early CTRCD.
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Giang et al. (2023) conducted a cohort in Breast cancer (n=351). Anthracycline chemotherapy was evaluated on Early cancer therapy-related cardiac dysfunction (CTRCD). Anthracycline chemotherapy was associated with early asymptomatic cancer therapy-related cardiac dysfunction in 5.1% of patients, best detected by left ventricular global longitudinal strain.
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