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Early detection of cardiotoxicity by 3D speckle tracking imaging of area strain in breast cancer patients receiving chemotherapy
Author(s) -
Chen Jianqiong,
Wang Ling,
Wu FangFang,
Sun Guoping
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14467
Subject(s) - epirubicin , medicine , chemotherapy , receiver operating characteristic , cardiotoxicity , anthracycline , breast cancer , troponin complex , chemotherapy regimen , cardiology , speckle tracking echocardiography , ejection fraction , cyclophosphamide , area under the curve , cancer , nuclear medicine , oncology , troponin , heart failure , myocardial infarction
Eighty‐three breast cancer patients who underwent six cycles of EC chemotherapy regimen (epirubicin + cyclophosphamide) without symptoms and signs of heart disease were enrolled in the study. Three‐dimensional speckle tracking imaging technique (3D‐ STI ) was used to measure left ventricular global area strain ( GAS ), overall annular strain ( GCS ), overall longitudinal strain ( GLS ), and overall radial strain ( GRS ). Meanwhile, serum troponin T (Hs‐ cTnT ) was measured. The clinical value of each index on cardiotoxicity after chemotherapy was analyzed using the receiver operating characteristic ( ROC ) curve. Hs‐ cTnT increased from the early stage to the end during chemotherapy, but it was still in the normal range. During the mid‐chemotherapy and the end‐chemotherapy, GAS , GLS , GCS , and E/A significantly reduced, while the changes in LVESV , LVEDV , LVEF , and GRS were not significant after chemotherapy. Pearson correlation analysis showed a significant negative correlation between GAS and anthracycline doses ( r = −.772, P < .01); GAS and Hs‐ cTnT were significantly negatively correlated ( P < .05). The area under the curve ( AUC ) of GAS , GLS , GCS , and GRS are 0.815, 0.683, 0.645, and 0.585, respectively. A GAS of −31.5% was used as the cutoff value for diagnosing left ventricular systolic dysfunction after receiving chemotherapy. The sensitivity of the previous parameters was 81.9%, and the specificity was 80.3%. Interobserver consistency analysis showed that 3D‐ STI strain parameter measurement has good repeatability. GAS has greater value in predicting early myocardial damage after anthracycline chemotherapy.