Heart India (Jan 2020)
Evaluation of left ventricular function using speckle-tracking echocardiography in patients on chemotherapy and/or thoracic radiotherapy
Abstract
Background: Chemotherapy and radiotherapy in cancer patients are associated with significant cardiotoxicity. Novel technique of speckle-tracking echocardiography (STE) may help in the early detection of cardiotoxicity in these patients. Aims and Objectives: The aim and objective of this study is to evaluate the left ventricular (LV) strain by STE in newly diagnosed cancer patients at baseline and to study the impact of chemotherapy and radiotherapy on these parameters in these patients. The present study was a prospective, observational study, done at a tertiary care center in North India. Methods and Results: This study was carried out on 30 patients with newly diagnosed malignancy and 15 aged- and gender-matched healthy controls. These patients underwent two-dimensional (2D) echocardiography and STE at baseline and after the completion of their treatment. Baseline characteristics and echocardiographic parameters were similar between the cases and controls. No significant difference in left ventricular ejection fraction was seen before and after cancer therapy (64.27 ± 3.25 vs. 62.6 ± 3.12; P = 0.63), whereas global longitudinal strain reduced significantly from –21.16 ± 2.50 before cancer therapy to –19.86 ± 3.22 after it (P < 0.01). The global circumferential strain was also reduced significantly from –23.60 ± 7.36 before cancer therapy to –21.33 ± 6.97 after it. A significant reduction in segment-wise longitudinal strain rate was observed among the cases after cancer therapy in all segments. Conclusions: The present study revealed that there was a significant worsening of LV systolic function as measured by the strain parameters on STE in cancer patients on chemotherapy and/or radiotherapy which was not detected by 2D echocardiography alone. STE may thus be a valuable tool in picking up early cardiotoxic changes in cancer patients.
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