Added value of global longitudinal strain assessment in early Detection of doxorubicin induced cardiotoxicity
Eslam Ahmed Mohamed Zeyara;
Abstract
SUMMARY
D
oxorubicin is a highly effective chemotherapeutic agents but it may cause cardiotoxicity.
The most commonly used practical and easily applicable definition of chemotherapy-induced cardiotoxicity is the presence of one or more of the following criteria: cardiomyopathy with reduction of LVEF, Symptoms or signs of heart failure (HF) and decline in initial LVEF of at least 5% to less than 55% in symptomatic patient, or decline in initial LVEF in the range of equal to or greater than 10% to less than 55% in asymptomatic patient.
DOX induced cardiotoxicity is a dose-dependent, leads to cell apoptosis, and is therefore irreversible at the cell level. Early detection and prompt treatment may prevent left ventricular remodeling and the progression to the heart failure .
Echocardiography is the method of choice for the evaluation patients before, during and after cancer therapy.
LVEF assessed by 2DE often fails to detect small changes in LV contractility.
The goal of the study was to determine the value of measuring global longitudinal strain with speckle tracking technique in patients receiving doxorubicin containing chemotherapy for early detection of left ventricular systolic dysfunction in comparison to conventional echocardiographic measures.
It was a cross sectional study involving fifty patient aged 27-61 years old with the mean age of (47.82 ± 8.73), 37 patients (74%) was females, 32 patients (64%) having breast cancer, 13 patients (26%) with non Hodgkin's lymphoma, 2 patients with chronic myeloid leukemia CML (4%), one patient with thyroid gland Ca, parotid gland Ca and Thymoma (2%) for each.all patient receive doxorubicin, echocardiography was done after 3-4 sessions of dose of DOX.
GLS was -15.86±2.16 while m-mode EF was 55.92±5.93 and Simpson´s EF was 52.40±5.01 and there was a highly significant statistical difference between GLS and EF done by either m-mode or Simpson's method in the early detection of DOX-induced cardiotoxicity p-value <0.001.
Accordingly, GLS was more sensitive to detect a larger number of patients with impaired LV systolic function compared EF measured by either m-mode or Simpson's method.
Therefore, all patients receiving a Doxorubicin for treatment of their malignancies should be strictly followed up by STE as it is the optimal parameter of deformation for the early detection of subclinical LV dysfunction and the same vendor-specific ultrasound machine should be used.
D
oxorubicin is a highly effective chemotherapeutic agents but it may cause cardiotoxicity.
The most commonly used practical and easily applicable definition of chemotherapy-induced cardiotoxicity is the presence of one or more of the following criteria: cardiomyopathy with reduction of LVEF, Symptoms or signs of heart failure (HF) and decline in initial LVEF of at least 5% to less than 55% in symptomatic patient, or decline in initial LVEF in the range of equal to or greater than 10% to less than 55% in asymptomatic patient.
DOX induced cardiotoxicity is a dose-dependent, leads to cell apoptosis, and is therefore irreversible at the cell level. Early detection and prompt treatment may prevent left ventricular remodeling and the progression to the heart failure .
Echocardiography is the method of choice for the evaluation patients before, during and after cancer therapy.
LVEF assessed by 2DE often fails to detect small changes in LV contractility.
The goal of the study was to determine the value of measuring global longitudinal strain with speckle tracking technique in patients receiving doxorubicin containing chemotherapy for early detection of left ventricular systolic dysfunction in comparison to conventional echocardiographic measures.
It was a cross sectional study involving fifty patient aged 27-61 years old with the mean age of (47.82 ± 8.73), 37 patients (74%) was females, 32 patients (64%) having breast cancer, 13 patients (26%) with non Hodgkin's lymphoma, 2 patients with chronic myeloid leukemia CML (4%), one patient with thyroid gland Ca, parotid gland Ca and Thymoma (2%) for each.all patient receive doxorubicin, echocardiography was done after 3-4 sessions of dose of DOX.
GLS was -15.86±2.16 while m-mode EF was 55.92±5.93 and Simpson´s EF was 52.40±5.01 and there was a highly significant statistical difference between GLS and EF done by either m-mode or Simpson's method in the early detection of DOX-induced cardiotoxicity p-value <0.001.
Accordingly, GLS was more sensitive to detect a larger number of patients with impaired LV systolic function compared EF measured by either m-mode or Simpson's method.
Therefore, all patients receiving a Doxorubicin for treatment of their malignancies should be strictly followed up by STE as it is the optimal parameter of deformation for the early detection of subclinical LV dysfunction and the same vendor-specific ultrasound machine should be used.
Other data
| Title | Added value of global longitudinal strain assessment in early Detection of doxorubicin induced cardiotoxicity | Other Titles | القيمه الإضافية لتقييم الجهد الطولي الكلى للكشف المبكر عن ضعف عضلة القلب الناتج عن استخدام عقار دوكسوروبيسين | Authors | Eslam Ahmed Mohamed Zeyara | Issue Date | 2015 |
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