Queenie Lo1, Leia Hee2, Vikneswary Batumalai2, Christine Allman3, Peter MacDonald4, Denise Lonergan5, Geoff P Delaney2, Liza Thomas6. 1. University of New South Wales, Sydney, Australia; Departments of Cardiology and Radiation Oncology, Liverpool Hospital, Sydney, Australia. 2. University of New South Wales, Sydney, Australia; Departments of Cardiology and Radiation Oncology, Liverpool Hospital, Sydney, Australia; Ingham Institute of Applied Medical Research, Liverpool, Australia. 3. Departments of Cardiology and Radiation Oncology, Liverpool Hospital, Sydney, Australia. 4. University of New South Wales, Sydney, Australia; Department of Cardiology, St Vincent's Hospital Sydney, Sydney, Australia. 5. Departments of Cardiology and Radiation Oncology, Liverpool Hospital, Sydney, Australia; Ingham Institute of Applied Medical Research, Liverpool, Australia. 6. University of New South Wales, Sydney, Australia; Departments of Cardiology and Radiation Oncology, Liverpool Hospital, Sydney, Australia; University of Sydney, Sydney, Australia; Department of Cardiology, Westmead Hospital, Sydney, Australia. Electronic address: l.thomas@unsw.edu.au.
Abstract
PURPOSE: We examined the utility of echocardiographic 2-dimensional speckle tracking strain imaging (SI) for the evaluation of segmental myocardial dysfunction before and after radiation therapy (RT) and the relationship to dose exposure. METHODS AND MATERIALS: We prospectively recruited 40 women with left-sided breast cancer, undergoing only adjuvant RT to the left chest. Comparisons of traditional echocardiographic parameters and SI parameters at baseline and 6 weeks after RT were analyzed. Regional strain and strain rate (SR) parameters were obtained from all 18 left ventricular segments. The correlation of change in strain parameters with segmental radiation dose was examined. RESULTS: We observed a significant reduction in global and segmental systolic strain parameters at 6 weeks after RT compared with baseline, with the largest decrement in the apical segments; this corresponded with the segments receiving the highest radiation dose exposure (apical peak systolic strain of -21.21% ± 3.49% before RT vs -18.69% ± 3.34% after RT, percentage change of 11.88%, P=.002; apical peak systolic SR of -1.17 ± 0.24 s-1 before RT vs -1.04 ± 0.19 s-1 after RT, percentage change of 11.11%, P=.008). There was a modest correlation between the apical segment systolic strain reduction and radiation dose exposure (apical segment Δ change and apical radiation dose, r=0.345, P=.031; apical segment percentage change and apical radiation dose, r=0.346, P=.031). A significant reduction in early diastolic SR was observed in the apical segments after treatment compared with baseline (apical early diastolic SR, 1.54 ± 0.45 s-1 before RT vs 1.35 ± 0.33 after RT s-1; percentage change, 12.34%; P=.034). CONCLUSIONS: Two-dimensional SI detected dose-related regional myocardial dysfunction in the acute phase after RT in chemotherapy-naive left-sided breast cancer patients. Although the long-term effects remain unknown, this imaging modality may have a potential role in the evaluation of irradiation-related cardiotoxicity.
PURPOSE: We examined the utility of echocardiographic 2-dimensional speckle tracking strain imaging (SI) for the evaluation of segmental myocardial dysfunction before and after radiation therapy (RT) and the relationship to dose exposure. METHODS AND MATERIALS: We prospectively recruited 40 women with left-sided breast cancer, undergoing only adjuvant RT to the left chest. Comparisons of traditional echocardiographic parameters and SI parameters at baseline and 6 weeks after RT were analyzed. Regional strain and strain rate (SR) parameters were obtained from all 18 left ventricular segments. The correlation of change in strain parameters with segmental radiation dose was examined. RESULTS: We observed a significant reduction in global and segmental systolic strain parameters at 6 weeks after RT compared with baseline, with the largest decrement in the apical segments; this corresponded with the segments receiving the highest radiation dose exposure (apical peak systolic strain of -21.21% ± 3.49% before RT vs -18.69% ± 3.34% after RT, percentage change of 11.88%, P=.002; apical peak systolic SR of -1.17 ± 0.24 s-1 before RT vs -1.04 ± 0.19 s-1 after RT, percentage change of 11.11%, P=.008). There was a modest correlation between the apical segment systolic strain reduction and radiation dose exposure (apical segment Δ change and apical radiation dose, r=0.345, P=.031; apical segment percentage change and apical radiation dose, r=0.346, P=.031). A significant reduction in early diastolic SR was observed in the apical segments after treatment compared with baseline (apical early diastolic SR, 1.54 ± 0.45 s-1 before RT vs 1.35 ± 0.33 after RT s-1; percentage change, 12.34%; P=.034). CONCLUSIONS: Two-dimensional SI detected dose-related regional myocardial dysfunction in the acute phase after RT in chemotherapy-naive left-sided breast cancerpatients. Although the long-term effects remain unknown, this imaging modality may have a potential role in the evaluation of irradiation-related cardiotoxicity.
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: Judy N Jacobse; Lars C Steggink; Gabe S Sonke; Michael Schaapveld; Yoran M Hummel; Tessa G Steenbruggen; Joop D Lefrandt; Janine Nuver; Anne P G Crijns; Berthe M P Aleman; Peter van der Meer; Jourik A Gietema; Flora E van Leeuwen Journal: Eur J Heart Fail Date: 2019-11-06 Impact factor: 15.534
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