Validity of baseline and sequential global longitudinal strain in prediction of Anthracyclines induced Cardiotoxicity

Khalil, Radwa Mohammed; Fikry, Mohammad Abdelwahab; Salem, Ahmed Mohamed

doi:10.21608/zumj.2024.302047.3464

Validity of baseline and sequential global longitudinal strain in prediction of Anthracyclines induced Cardiotoxicity

Document Type : Original Article

Authors

¹ Cardiology Department ,Faculty of Medicine , Zagazig University ,Zagazig, Egypt

² Cardiology Department , Faculty of Medicine , Zagazig University ,Zagazig ,Egypt

³ Cardiology Department , Faculty of Medicine, Zagazig University ,Zagazig ,Egypt

10.21608/zumj.2024.302047.3464

Abstract

Background: Hematologic cancers and solid tumors are frequently treated with anthracyclines. In approximately 9% of patients, they may cause cardiac dysfunction associated to cancer therapy (CTRD). Two-dimensional speckle tracking echocardiography (STE) with global longitudinal strain (GLS) and left atrial strain (LAS) have been developed as a significant and established tools for predicting subsequent CTRD during anthracycline therapy. CTRD is traditionally defined as a decreased left ventricular ejection fraction (LVEF) of less than 50% or ≥ 5% absolute reduction in symptomatic patients or ≥10% in asymptomatic patients.

Methods: A cohort prospective study was carried out in the Cardiology department from February 2023 to May 2024. Prior to receiving chemotherapy, 143 patients had evaluations. Serial echocardiography was carried out at 0, 3, 6, and up to a year's follow-up, with 2D-STE conducted at 0 and 3 months.

Results &Conclusion

This one-year cohort research comprised 143 patients receiving anthracycline chemotherapy (mean age of 56 years, 77.6% women). We evaluated the predictive relevance of LV GLS, LAs, brain natriuretic peptide (BNP), and troponin (TnT). Cardiotoxcity was consistently associated with proportionate reductions in LV GLS, LASct, and LASr, as well as 3-month increases in BNP levels. Multivariate Cox Regression Analysis showed that at 3 months after treatment, the development of cardiotoxicity was highly accurately and independently linked with Δ LV GLS ≥ 18.4%.

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