BACKGROUND: Despite speckle tracking echocardiography (STE) has emerged as a sensitive technique for identifying myocardial dysfunction, there are little data available on the appropriate timing to perform STE in the serial assessment after anthracycline administration. Moreover, further uncertainty is increased in the context of STE application in diffuse large B-cell lymphoma (DLBCL) research, as most recommendations are inferred by studies conducted primarily in breast cancer. OBJECTIVE: This study aimed to determine whether early measurement of strain parameters derived by STE could predict the development of cardiotoxicity. METHODS: Sixty-five patients were included in the final analysis. The patients were evaluated at baseline, after the third cycle and sixth-eighth cycle, and during follow-up. Global longitudinal strain (GLS) was analyzed using STE, and left ventricular ejection fraction (LVEF) was calculated by real time 3D echocardiography (RT3DE). RESULTS: There was a significant decrease in GLS after the third cycle of chemotherapy and remained decreased during subsequent follow-up, whereas LVEF decreased only at follow-up. A percentage reduction in GLS of 13.8% between baseline and the third cycle of chemotherapy was the best predictor of further LVEF reduction. CONCLUSION: Earlier monitoring timing and more accurate assessment methods might be helpful in the prevention of irreversible heart failure.
BACKGROUND: Despite speckle tracking echocardiography (STE) has emerged as a sensitive technique for identifying myocardial dysfunction, there are little data available on the appropriate timing to perform STE in the serial assessment after anthracycline administration. Moreover, further uncertainty is increased in the context of STE application in diffuse large B-cell lymphoma (DLBCL) research, as most recommendations are inferred by studies conducted primarily in breast cancer. OBJECTIVE: This study aimed to determine whether early measurement of strain parameters derived by STE could predict the development of cardiotoxicity. METHODS: Sixty-five patients were included in the final analysis. The patients were evaluated at baseline, after the third cycle and sixth-eighth cycle, and during follow-up. Global longitudinal strain (GLS) was analyzed using STE, and left ventricular ejection fraction (LVEF) was calculated by real time 3D echocardiography (RT3DE). RESULTS: There was a significant decrease in GLS after the third cycle of chemotherapy and remained decreased during subsequent follow-up, whereas LVEF decreased only at follow-up. A percentage reduction in GLS of 13.8% between baseline and the third cycle of chemotherapy was the best predictor of further LVEF reduction. CONCLUSION: Earlier monitoring timing and more accurate assessment methods might be helpful in the prevention of irreversible heart failure.
Authors: Phillipp Hofrichter; Andreas Hagendorff; Ulrich Laufs; Sven Fikenzer; Pierre Hepp; Robert Percy Marshall; Bhupendar Tayal; Stephan Stöbe Journal: Int J Cardiovasc Imaging Date: 2021-03-18 Impact factor: 2.357