Altered left ventricular longitudinal diastolic function correlates with reduced systolic function immediately after...

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Anthracycline chemotherapy is vital for cancer treatment but can cause cardiotoxicity.
• Monitoring left ventricular systolic function via echocardiography is standard for detecting cardiotoxicity.
• Early detection of cardiac changes is crucial for managing chemotherapy-induced cardiotoxicity.

Purpose of the Study:

• To investigate if anthracycline chemotherapy-induced changes in systolic function are associated with alterations in diastolic parameters.
• To utilize two-dimensional speckle tracking echocardiography (2DSTE) for assessing cardiac function before and after chemotherapy.

Main Methods:

• Fifty-two breast cancer patients underwent echocardiography before and after anthracycline chemotherapy.
• Two-dimensional speckle tracking echocardiography (2DSTE), conventional Doppler, and tissue velocity imaging (TVI) were used.
• Measurements included longitudinal systolic strain and diastolic parameters like early diastolic strain rate (E-Sr).

Main Results:

• Altered left ventricular diastolic function, including reduced E-Sr, was observed in the entire cohort post-chemotherapy.
• A differential reduction in diastolic function was noted in patients with a post-therapy left ventricular ejection fraction (LVEF) <55%.
• Pre-chemotherapy systolic strain predicted reduced E-Sr post-therapy, and post-chemotherapy systolic strain was the strongest independent predictor of diastolic dysfunction.

Conclusions:

• Therapeutic doses of anthracycline chemotherapy induce altered left ventricular diastolic function immediately after administration.
• Changes in diastolic function following chemotherapy are associated with reduced systolic function.
• 2DSTE is a valuable tool for detecting early cardiac changes related to cardiotoxicity.