Evaluation of the cardiac function in patients with breast cancer before and after receiving anthracycline by three-dimensional speckle tracking imaging

Abstract

Objective To probe the clinical value of three-dimensional speckle tracking echocardiography in evaluating the early ventricular myocardial dysfunction in breast cancer patients treated with anthracycline. Methods A group of 40 breast cancer postoperative patients were received a epirubicin-based chemotherapy. Conventional and 3D dynamic echocardiography were measured before chemotherapy and 2 cycles and 4 cycles after chemotherapy during 24 hours, and to compare the change of the parameters before and after the chemotherapy. Results Left ventricular global area strain(LVGAS), left ventricular global longitudinal strain(LVGLS), right ventricular global longitudinal strain(RVGLS), right ventricular global circular strain(RVGCS) and right ventricular global radial strain(RVGRS) were significantly lower after the chemotherapy than those before the chemotherapy, and negatively correlated to cumulative anthracycline dose, in which the area under the ROC curve of LVGAS was 0.897(P=0.000). If -30.55% was selected as the diagnosis cut-off point, the sensitivity was 0.857, and the specificity was 0.917; some of right ventricular strain parameters were earlier than those of the left. Conclusions 3D-STI is useful to find the early left and right ventricular myocardial dysfunction in breast cancer patients treated with anthracycline and early access the subclinical cardiactoxicity, and right ventricular dysfunction may emerge earlier than the left, which can provide diagnosis basis to intervene timely for the clinical. Key words: Echocardiography, three-dimensional; Anthracycline; Breast neoplasms; Ventricular function; Speckle tracking image