Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography

Abstract

To examine the subclinical myocardial injury shortly after epirubicin exposure in asymptomatic patients with large B-cell non-Hodgkin lymphoma using 2-dimensional (2D) speckle tracking echocardiography. Sixty-seven patients aged 52.58 ± 13.86 years with large B-cell non-Hodgkin lymphoma treated with epirubicin were studied. Echocardiography was performed at baseline and 1 day after completion of the therapy. Global and regional longitudinal (LS), circumferential (CS) and radial strain (RS), standard deviation of time to peak LS (TLS-SD), CS (TCS-SD), RS(TRS-SD) were calculated using 2D speckle tracking echocardiography. Despite normal left ventricular ejection fraction, global LS (-18.30 ± 1.87% vs.-16.18 ± 1.92%; p < 0.01), CS (-20.37 ± 2.89% vs. -18.25 ± 2.40%, p < 0.01) and RS (39.95 ± 5.79% vs. 36.15 ± 5.79%, p < 0.01), were remarkably reduced compared to baseline values. However, TLS-SD, TCS-SD and TRS-SD showed no significant difference after epirubicin exposure. Hypertension was an independent predictor of reduction of global LS, CS and RS. Subtle abnormalities in myocardial systolic function were present in asymptomatic patients shortly after anthracycline exposure, which could be detected by 2D speckle tracking echocardiography.