Significance of global longitudinal systolic deformation by two-dimensional image for early diagnostics of chemotherapy-induced cardiotoxicity (preliminary data)
Nevsetov V. V., Shkolnik E. L., Vasyuk Yu. A.
Keywords: diagnostics, breast cancer, chemotherapy, CHF, echocardiography
Background. In recent years, a significant decrease in mortality from oncologic diseases has been observed. This progress is due to both early diagnosis and more aggressive treatment of the detected disease. Despite high efficacy, some chemotherapies are associated with a risk of myocardial injury, even development of cardiomyopathy and CHF. Correction of the myocardial injury is most effective before appearance of clinically evident cardiomyopathy and considerable impairment of LV contractility. Aim. To evaluate the significance of global longitudinal systolic deformation using the two-dimensional image for early diagnosis of chemotherapy cardiotoxicity. Materials and methods. The study included 17 female patients with breast cancer without cardiovascular disease, who had undergone surgery treatment and were scheduled for chemotherapy with antracycline group drugs. EchoCG examination including analyses of LV EF (modified Simpson method) and global longitudinal systolic deformation by two-dimensional image (specialized workstation Echopac, General Electric) were performed for all patients during inclusion in the study and at 3 months of chemotherapy initiation. Results. For the whole group, LV EF remained unchanged during the treatment (61.3±4.0 % and 62.1±3.1 %; p=0.544). At the same time, a clinically significant decrease in LV EF by >5 % observed in 2 patients (11 %). In one of these patients, this decrease exceeded 10 %. In none of the patients, LV EF decreased below 50 %. Analysis of global longitudinal systolic deformation also did not reveal any significant changes (–19.7±2.1 % and –19.3±2.1 %; p=0.44). At the same time, 11 (65 %) patients showed reduced global longitudinal deformation. In 5 (29 %) patients, the port-treatment actual value of LV global deformation decreased below the normal range (18.4 %) and in 3 (18 %) patients, the decrease was more than 10 %. Conclusion. Global longitudinal systolic LV myocardial deformation is a sensitive marker of myocardial injury during chemotherapy and can be used for early detection of myocardial injury.
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Nevsetov V.V., Shkolnik E.L., Vasyuk Yu.A. Significance of global longitudinal systolic deformation by two-dimensional image for early diagnostics of chemotherapy-induced cardiotoxicity (preliminary data). Russian Heart Failure Journal. 2013;14 (3):127-130