Queenie Lo1, Leia Hee2, Vikneswary Batumalai2, Christine Allman3, Peter MacDonald4, Geoff P Delaney2, Denise Lonergan5, Liza Thomas6. 1. University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia. 2. University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia. 3. Liverpool Hospital, Sydney, NSW, Australia. 4. University of New South Wales, Sydney, NSW, Australia; St. Vincent's Hospital, Sydney, NSW, Australia. 5. Liverpool Hospital, Sydney, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia. 6. University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia. Electronic address: l.thomas@unsw.edu.au.
Abstract
PURPOSE: To evaluate 2-dimensional strain imaging (SI) for the detection of subclinical myocardial dysfunction during and after radiation therapy (RT). METHODS AND MATERIALS: Forty women with left-sided breast cancer, undergoing only adjuvant RT to the left chest, were prospectively recruited. Standard echocardiography and SI were performed at baseline, during RT, and 6 weeks after RT. Strain (S) and strain rate (Sr) parameters were measured in the longitudinal, circumferential, and radial planes. Correlation of change in global longitudinal strain (GLS % and Δ change) and the volume of heart receiving 30 Gy (V30) and mean heart dose (MHD) were examined. RESULTS: Left ventricular ejection fraction was unchanged; however, longitudinal systolic S and Sr and radial S were significantly reduced during RT and remained reduced at 6 weeks after treatment [longitudinal S (%) -20.44 ± 2.66 baseline vs -18.60 ± 2.70* during RT vs -18.34 ± 2.86* at 6 weeks after RT; longitudinal Sr (s(-1)) -1.19 ± 0.21 vs -1.06 ± 0.18* vs -1.06 ± 0.16*; radial S (%) 56.66 ± 18.57 vs 46.93 ± 14.56* vs 49.22 ± 15.81*; *P<.05 vs baseline]. Diastolic Sr were only reduced 6 weeks after RT [longitudinal E Sr (s(-1)) 1.47 ± 0.32 vs 1.29 ± 0.27*; longitudinal A Sr (s(-1)) 1.19 ± 0.31 vs 1.03 ± 0.24*; *P<.05 vs baseline], whereas circumferential strain was preserved throughout. A modest correlation between S and Sr and V30 and MHD was observed (GLS Δ change and V30 ρ = 0.314, P=.05; GLS % change and V30 ρ = 0.288, P=.076; GLS Δ change and MHD ρ = 0.348, P=.03; GLS % change and MHD ρ = 0.346, P=.031). CONCLUSIONS: Subclinical myocardial dysfunction was detected by 2-dimensional SI during RT, with changes persisting 6 weeks after treatment, though long-term effects remain unknown. Additionally, a modest correlation between strain reduction and radiation dose was observed.
PURPOSE: To evaluate 2-dimensional strain imaging (SI) for the detection of subclinical myocardial dysfunction during and after radiation therapy (RT). METHODS AND MATERIALS: Forty women with left-sided breast cancer, undergoing only adjuvant RT to the left chest, were prospectively recruited. Standard echocardiography and SI were performed at baseline, during RT, and 6 weeks after RT. Strain (S) and strain rate (Sr) parameters were measured in the longitudinal, circumferential, and radial planes. Correlation of change in global longitudinal strain (GLS % and Δ change) and the volume of heart receiving 30 Gy (V30) and mean heart dose (MHD) were examined. RESULTS: Left ventricular ejection fraction was unchanged; however, longitudinal systolic S and Sr and radial S were significantly reduced during RT and remained reduced at 6 weeks after treatment [longitudinal S (%) -20.44 ± 2.66 baseline vs -18.60 ± 2.70* during RT vs -18.34 ± 2.86* at 6 weeks after RT; longitudinal Sr (s(-1)) -1.19 ± 0.21 vs -1.06 ± 0.18* vs -1.06 ± 0.16*; radial S (%) 56.66 ± 18.57 vs 46.93 ± 14.56* vs 49.22 ± 15.81*; *P<.05 vs baseline]. Diastolic Sr were only reduced 6 weeks after RT [longitudinal E Sr (s(-1)) 1.47 ± 0.32 vs 1.29 ± 0.27*; longitudinal A Sr (s(-1)) 1.19 ± 0.31 vs 1.03 ± 0.24*; *P<.05 vs baseline], whereas circumferential strain was preserved throughout. A modest correlation between S and Sr and V30 and MHD was observed (GLS Δ change and V30 ρ = 0.314, P=.05; GLS % change and V30 ρ = 0.288, P=.076; GLS Δ change and MHD ρ = 0.348, P=.03; GLS % change and MHD ρ = 0.346, P=.031). CONCLUSIONS: Subclinical myocardial dysfunction was detected by 2-dimensional SI during RT, with changes persisting 6 weeks after treatment, though long-term effects remain unknown. Additionally, a modest correlation between strain reduction and radiation dose was observed.
Authors: Anthony F Yu; Alice Y Ho; Lior Z Braunstein; Maria E Thor; Katherine Lee Chuy; Anne Eaton; Elton Mara; Oren Cahlon; Chau T Dang; Kevin C Oeffinger; Richard M Steingart; Jennifer E Liu Journal: J Am Soc Echocardiogr Date: 2019-02-28 Impact factor: 5.251
Authors: Robert W Mutter; J Isabelle Choi; Rachel B Jimenez; Youlia M Kirova; Marcio Fagundes; Bruce G Haffty; Richard A Amos; Julie A Bradley; Peter Y Chen; Xuanfeng Ding; Antoinette M Carr; Leslie M Taylor; Mark Pankuch; Raymond B Mailhot Vega; Alice Y Ho; Petra Witt Nyström; Lisa A McGee; James J Urbanic; Oren Cahlon; John H Maduro; Shannon M MacDonald Journal: Int J Radiat Oncol Biol Phys Date: 2021-05-25 Impact factor: 8.013
Authors: Valentin Walker; Anne Crijns; Johannes Langendijk; Daan Spoor; Rozemarijn Vliegenthart; Stephanie E Combs; Michael Mayinger; Arantxa Eraso; Ferran Guedea; Manuela Fiuza; Susana Constantino; Radia Tamarat; Dominique Laurier; Jean Ferrières; Elie Mousseaux; Elisabeth Cardis; Sophie Jacob Journal: JMIR Res Protoc Date: 2018-10-01