C9 THE EFFECT OF ANTHRACYCLINE CHEMOTHERAPY ON PEAK LEFT ATRIAL LONGITUDINAL STRAIN: A METANALYSIS

Abstract

Abstract Background Currently there is a limited number of studies reporting atrial function, evaluated by peak left atrial longitudinal strain (PALS), among patients undergoing anthracycline chemotherapy. Objective We investigated this issue through a meta–analysis of echocardiography studies that reported data on: A) PALS before and after anthracycline chemotherapy and B) PALS in patients who have previously received anthracycline chemotherapy versus controls. Methods The PubMed, OVID–MEDLINE and Cochrane library databases were systematically analysed to search articles and abstracts published from inception to 29th December 2022. Studies were identified by using Me–SH terms and crossing the following terms: “left atrial strain”, AND “cardiotoxicity”, “anthracycline”, “anthracycline cardiotoxicity” and “echocardiography”. Results The meta–analysis included a total of 967 patients from 10 studies. A) The metanalysis of six studies evaluating PALS before and after anthracycline chemotherapy in a total of 343 patients showed a significant PALS worsening after anthracycline (30,05±2,5 vs 26,8±3,1) with standard mean difference (SMD) being –0,27±0,06, p < 0.0001. Figure 1 panel A. B) Five studies evaluated PALS in 359 patients who have previously received anthracycline chemotherapy versus 356 controls. Compared with controls, PALS was significantly worse in the pooled anthracycline group (34,63±1,8 vs 37,64±2,7) with SMD being –0.35 ± 0,08, p < 0.0001. Figure 1 panel B. Conclusions Our metanalysis suggests a detrimental effect of anthracycline chemotherapy on atrial function evaluated by PALS.