Early Detection of Cardiotoxicity in patients receiving cancer Chemotherapy Using three-dimensional and Speckle Tracking Echocardiography

Abstract

Background: Cancer and cardiovascular diseases are prevalent worldwide, especially in the developed world. Chemotherapeutic agents can cause short- and long-term cardiotoxic effects ranging from asymptomatic and transient to clinically significant and long-lasting cardiac events. Using of left ventricular ejection fraction (LVEF) is considered the most important component in the prediction and detection of cardiotoxicity caused by chemotherapy. The drop in LVEF occurs mostly in the last stages, and hence, it is not sensitive in picking early cardiac toxicity. A reduction in global longitudinal strain (GLS) by speckle tracking echocardiography (STE) is proposed to be the earliest indicator of myocardial dysfunction. This study aimed to assess the role of STE and three-dimensional (3D) EF in early detection of cardiotoxicity in patients receiving cardio-toxic chemotherapy. Materials and Methods: This is a cohort prospective study that was carried out in Benha University Hospitals were 99 patients with different malignancies on different chemotherapeutic regimens were recruited aiming to evaluate the role of 3D echocardiography in early detection of cardiotoxicity of chemotherapy, thorough history, examination, and 3D echocardiography was done. Results: In this study, 99 patients were included, with mean of age was 55 years, 30.3% of patients were males and 66.7% of patients were female. The median two-dimensional EF was 67.3%, which decreased to 63.0% at 3 m follow-up. While 3D EF was 60.25%, which decreased to 56.0% at 3 m follow-up. GLS was − 22.5 at 0 m and − 20.4 at 3 m follow-up. GLS reduction ≥−8.9% at 3 months follow-up correlated with decreased 3D EF%