Key result
Chest radiotherapy linked to ~6% relative decline in GLS at 3 years in breast cancer.
Why the study?
Chest radiotherapy doubles late cardiac mortality, but the evolution of cardiac changes in speckle tracking echocardiography over three years was not well characterized.
Does chest radiotherapy induce changes in left ventricular speckle tracking echocardiography in chemotherapy-naïve early-stage breast cancer patients?
Cohort (n=81)
Does chest radiotherapy induce changes in left ventricular speckle tracking echocardiography in chemotherapy-naïve early-stage breast cancer patients?
Absolute Event Rate: -17% vs -18%
p-value: p=0.015
Contemporary chest radiotherapy induces progressive global and regional decline in left ventricular speckle tracking echocardiography at three years follow-up in early-stage breast cancer patients.
GLS decline after radiotherapy may signal subclinical cardiotoxicity warranting surveillance; leaves open prognostic value and intervention thresholds in early breast cancer.
BACKGROUND/AIM: Chest radiotherapy (RT) doubles late cardiac mortality. This study aimed to evaluate the evolution of cardiac changes in speckle tracking echocardiography during a three-year follow-up. MATERIALS AND METHODS: This prospective study included 81 chemotherapy-naïve early-stage breast cancer patients who were evaluated at baseline, immediately after RT and three years after RT. Sixty-one patients had left-sided (LSBC) and 20 right-sided breast cancer (RSBC). RESULTS: Global longitudinal strain (GLS) declined from baseline -18.0±3.3% to -17.0±3.0% (p=0.015) at the three-year follow-up examination. A decline over 15% (GLS15) was observed in 19 (27%) patients. GLS15 was independently associated with aromatase inhibitor use (β=-1.977, p=0.001). In regional analysis, patients with LSBC had apical strain decline by 3.2±5.5% (p<0.001) and patients with RSBC showed basal rotation decline by 1.8° (-0.2°, 3.8°) (p=0.030). CONCLUSION: Even contemporary RT induced progressive global and regional decline in speckle tracking analysis. The regional changes complied with RT fields.
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TUOHINEN et al. (2019) conducted a cohort in Early-stage breast cancer (n=81). Chest radiotherapy vs. Baseline was evaluated on Global longitudinal strain (GLS) (p=0.015). Chest radiotherapy induced a progressive decline in global longitudinal strain from -18.0% at baseline to -17.0% at three years (p=0.015) in chemotherapy-naïve early-stage breast cancer patients.
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