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231679

Value of Left Ventricular Global Longitudinal Strain Assessed by Two-Dimensional Strain Imaging in Early Detection of Anthracycline Mediated Cardiotoxicity

Article

Last updated: 22 Jan 2023

Subjects

-

Tags

Internal medicine ·

Abstract

The goal of this study is to investigate whether alterations of myocardial global longitudinal strain and high‐sensitive cardiac troponin could be detected early in patients receiving anthracycline chemotherapy & if it could predict future cardiac dysfunction. Methods: Thirty patients with cancer treated with Adriamycin were studied. Blood collection for measurement of high sensitive troponin and echocardiography were performed at baseline, three months & six months of chemotherapy. Global longitudinal strain (GLS), were calculated using speckle tracking echocardiography. Left ventricular ejection fraction was measured by M-mode echocardiography.  Results: LVEF although reduced after treatment, remained within the normal range (65±3.6% at base line vs. 63±2.7% at three months vs. 62±2.6% at six months of treatment, p = 0.002).LVIDd & LVIDs was highest after 6 months of chemotherapy. GLS was significantly reduced after treatment (-20.56±1.9% vs. -18.2±2.2% at three months vs -17.1±2.1 at six months of treatment, p < 0.001). Subclinical LV dysfunction (>15% reduction in GLS compared to before therapy) occurred in 43%. Serum hs‐cTnI levels increased significantly after 3 months of treatment with anthracycline (0.0088± 0.012, vs. 0.345 ± 0.5 after three months of treatment, p = 0.001).There was positive correlation between EF & GLS while a negative correlation was found between hscTnI & GLS. Hs‐cTnI assays was significantly increased in patients with Drop in GLS as compared with patients with no Drop in GLS after 3 months follow-up. No statistically significant difference between drop in GLS or hs-cTnI levels and cumulative dose of anthracyclines. No clinical parameters were associated with the drop in GLS or elevation of hs‐cTnI levels. Conclusion: Measurement of LV GLS by 2D STE during & after anthracycline therapy combined with hs-cTnI assay may allow an early identification of cardiac damage and therefore provide a way to minimize cardiac related mortality and morbidity while undergoing chemotherapy and afterwards.

DOI

10.21608/ejmr.2022.231679

Keywords

Anthracycline, cardiotoxicity, global longitudinal strain

Authors

First Name

Yasser

Last Name

Abdel-Hady

MiddleName

Ahmed

Affiliation

Cardiology department, Faculty of Medicine, Beni-Suef University, Egypt

Email

yasser.abdelhady@icloud.com

City

-

Orcid

0000-0001-9019-5312

First Name

Mohamed

Last Name

Aly El-Wakil

MiddleName

-

Affiliation

Oncology department, Faculty of Medicine, Beni-Suef University, Egypt

Email

-

City

-

Orcid

-

First Name

Khaled

Last Name

Abd El-Meguid

MiddleName

Refaat

Affiliation

Cardiology department, Faculty of Medicine, Beni-Suef University, Egypt

Email

-

City

-

Orcid

-

First Name

Khadiga

Last Name

Abosaif

MiddleName

Mohamed

Affiliation

Cardiology department, Faculty of Medicine, Beni-Suef University, Egypt

Email

-

City

-

Orcid

-

Volume

3

Article Issue

2

Related Issue

32883

Issue Date

2022-04-01

Receive Date

2022-04-18

Publish Date

2022-04-01

Page Start

23

Page End

47

Print ISSN

2682-4396

Online ISSN

2682-440X

Link

https://ejmr.journals.ekb.eg/article_231679.html

Detail API

https://ejmr.journals.ekb.eg/service?article_code=231679

Order

2

Type

Original Article

Type Code

1,224

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Research

Publication Link

https://ejmr.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023