Two-dimensional speckle tracking imaging in assessing the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy

Abstract

Objective To evaluate the early injury and dynamic changes of the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy by using two-dimensional speckle tracking imaging (2D-STI). Methods From 2017 to 2018, echocardiography examinations were performed in 39 patients with esophageal carcinoma before, during and after the first thoracic radiotherapy to measure the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), early diastolic mitral flow velocity/early diastolic mitral annular peak velocity (E/e′), left atrial volume (LAV), 2D-STI parameters including the left ventricular global longitudinal strain (GLS), global systolic stain rate (GSRs), global early diastolic strain rate (GSRe), global late diastolic strain rate (GSRa) and E/GSRe ratio. According to the GLS of patients with esophageal carcinoma after radiotherapy (cumulative dose≥50 Gy), the patients were divided into good prognosis (n=23) and poor prognosis groups (n=16). The E/GSRe ratio was statistically compared between two groups. Results The E/e′and LAVI were increased significantly only after radiotherapy (both P<0.05), and LVEF was decreased significantly only after radiotherapy (P<0.05). The e′ tended to decline before, during and after radiotherapy (all P<0.05). GLS and GSRs were significantly decreased only after radiotherapy (both P<0.05), whereas GSRa was considerably decreased during radiotherapy (P<0.05). E/GSRe tended to increase (P<0.05). Compared with the good prognosis group, E/GSRe was significantly increased after radiotherapy in the poor prognosis group (P<0.05). Conclusions Diastolic dysfunction can occur in the early stage of radiation-induced heart injury. The global diastolic strain rate and E/GSRe obtained by 2D-STI can be used to assess the early left ventricular dysfunction. E/GSRe can be more sensitive to evaluate the clinical prognosis compared with the global diastolic strain rate. Key words: Two-dimensional speckle tracking imaging; Ventricular diastolic function; Esophageal neoplasm/radiotherapy