APPLICATION OF 2D AND 3D SPECKLE TRACKING IMAGING IN THE ASSESSMENT OF EARLY CARDIOTOXICITY OF CHEMOTHERAPY IN PATIENTS WITH BREAST CANCER AND ARTERIAL HYPERTENSION

Abstract

Objective: to study of subclinical cardiotoxicity of two anthracycline-containing chemotherapy regimens in breast cancer (BC) patients with normotension and arterial hypertension (AH).Design and method: 119 women [mean age 48,810,9 years] with BC were enrolled. Depending on the chemotherapy, the patients were divided into two groups: group I (n = 54) - treatment duration 8 weeks, cumulative dose of doxorubicin was 200 mg / m2, group II (n = 65) - treatment duration 16 weeks., the cumulative dose of doxorubicin was 320 mg / m2. Before and after chemotherapy completion of all patients ultrasound was performed, including 2D and 3D Speckle Tracking Imaging (STI). Results: In patients who received a higher cumulative dose of doxorubicin (group II), a statistically significant decrease in GLS was observed according to 2D and 3 D STI (table). The frequency of the diagnostic reduction of the GLS by more than 15% from the initial level, which characterizes subclinical cardiotoxicity, was significantly higher in patients of group II: 33.3% and 18.5% of patients, respectively, p < 0.05. The most pronounced changes in the strain were observed in patients with AH, especially in group II. Thus, in patients with BC and AH of group I (n = 18), the decrease in GLS according to the 2 D STI was from −19.6 ± 1.1% to - 17.4 ± 0.5%, p = 0.06, and according to 3 D STI - from −9.9 ± 0.5% to −6.6 ± 0.4%, p < 0.05. In patients with AH of group II (n = 13), the decrease in GLS according to the data of 2D STI was from −18.5 ± 1.1% to −15.6 ± 0.6%, p < 0.05, and according to the data of the 3 D STI - from −9.7 ± ± 0.6% to −6.5 ± 0.5%, p < 0.05. Conclusions: the increased risk of subclinical cardiotoxicity was associated with a higher cumulative dose of doxorubicin (320 mg / m2), as well as in patients with BC with AH.