Combined Utility of Speckle Tracking Echocardiography and Cardiac Biomarkers for Early Detection of Anthracycline-Induced Cardiotoxicity in Pediatric Oncology Patients

Abstract

Background and Objectives: Anthracycline chemotherapy is a cornerstone in pediatric oncology but carries a significant risk of cardiotoxicity. The early detection of cardiac dysfunction is crucial for timely intervention. This study aims to evaluate the predictive value of combining speckle tracking echocardiography (STE) parameters with traditional cardiac biomarkers for the early detection of anthracycline-induced cardiotoxicity in pediatric oncology patients. Methods: A retrospective cohort study was conducted, involving 99 pediatric oncology patients undergoing anthracycline therapy and 50 age- and sex-matched healthy controls. Cardiac function was assessed using STE parameters—global longitudinal strain (GLS), Simpson’s method of disk ejection fraction (SMOD EF), and myocardial performance index (MPI)—alongside biomarkers including cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP). Assessments were performed at baseline and at 3, 6, and 12 months post-therapy initiation. Results: A total of 28.3% of patients developed cardiotoxicity based on the LVEF decrease. Significant differences were observed between oncological patients under anthracycline treatment and healthy controls. Patients had reduced GLS (−16.1 ± 4.7% vs. −19.6 ± 5.1%, p p p p p < 0.001). Conclusions: Combining STE parameters with cardiac biomarkers enhances the early detection of anthracycline-induced cardiotoxicity in pediatric oncology patients. This combined assessment may facilitate timely interventions to prevent long-term cardiac complications.

Keywords

• pediatric oncology
• anthracycline cardiotoxicity
• speckle tracking echocardiography
• cardiac biomarkers
• early detection