Key result
Decreased baseline GLS is linked to ~12-fold greater risk of cancer therapy-related cardiac dysfunction.
Why the study?
The prognostic value of baseline left ventricular global longitudinal strain for predicting cancer therapy-related cardiac dysfunction in moderate- to high-risk patients undergoing anthracycline chemotherapy remained unclear.
Does decreased baseline global longitudinal strain predict cancer therapy-related cardiac dysfunction in moderate- to high-risk cancer patients undergoing anthracycline chemotherapy?
Observational (n=80)
No
Does decreased baseline global longitudinal strain predict cancer therapy-related cardiac dysfunction in moderate- to high-risk cancer patients undergoing anthracycline chemotherapy?
Relative Risk: 12 (95% CI 2–71.9)
p-value: p=0.0065
Decreased baseline global longitudinal strain (≥−18%) strongly predicts the development of cancer therapy-related cardiac dysfunction and all-cause mortality in moderate- to high-risk patients receiving anthracyclines.
Background: Anthracycline-based chemotherapy is associated with a risk of cancer therapy-related cardiac dysfunction (CTRCD), particularly in patients with moderate to high cardiovascular risk. Left ventricular global longitudinal strain (GLS) is a sensitive marker for early myocardial dysfunction, but the prognostic value of baseline GLS in this population remains unclear. Objective: We aimed to evaluate whether baseline GLS can predict CTRCD in moderate- to high-risk cancer patients undergoing anthracycline chemotherapy. Methods: In this prospective, single-center observational study, 80 anthracycline-naive cancer patients classified as moderate or high risk were enrolled. Baseline GLS was assessed via speckle-tracking echocardiography, with a threshold of ≥−18% considered decreased. Patients were followed for 12 months, and the primary endpoint was the development of CTRCD per ESC 2022 Cardio-oncology guidelines. Results: Of the 77 patients completing follow-up, 27.3% had decreased baseline GLS. CTRCD occurred in 62.4% of patients, with higher incidence among those with decreased GLS (76.7%) compared to those with normal GLS. In multivariable analysis, GLS ≥−18% was the only significant independent predictor of CTRCD (RR 12.0, 95% CI 2.0–71.9; p = 0.0065). All-cause mortality was also significantly higher in patients with decreased baseline GLS (19.1% vs. 1.8%, p = 0.018). Conclusions: Decreased baseline global longitudinal strain is an independent predictor of cancer therapy-related cardiac dysfunction and all-cause mortality in moderate- to high-risk patients receiving anthracycline therapy. These findings support the inclusion of baseline GLS in pre-treatment cardiovascular risk assessment, particularly in patients with an LVEF above 54%, to more effectively identify those who may benefit from early cardioprotective interventions.
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Borowiec et al. (2025) conducted an observational in Cancer patients undergoing anthracycline chemotherapy (n=80). Decreased baseline global longitudinal strain (GLS ≥−18%) vs. Normal baseline global longitudinal strain was evaluated on Development of CTRCD per ESC 2022 Cardio-oncology guidelines (RR 12.0, 95% CI 2.0-71.9, p=0.0065). Decreased baseline global longitudinal strain (≥−18%) independently predicted the development of cancer therapy-related cardiac dysfunction (RR 12.0; 95% CI 2.0-71.9; p=0.0065).
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