Relationship between regional left ventricular dysfunction and cancer-therapy-related cardiac dysfunction

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Cancer therapies, particularly anthracyclines, can lead to cardiotoxicity.
• Early detection of cancer-therapy-related cardiac dysfunction (CTRCD) is crucial for patient management.
• Echocardiography is a key tool for assessing cardiac function during cancer treatment.

Purpose of the Study:

• To evaluate the association between changes in echocardiographic measures and the risk of CTRCD.
• To determine if regional left ventricular (LV) systolic dysfunction predicts CTRCD development after anthracycline therapy.

Main Methods:

• Retrospective analysis of 87 patients receiving anthracyclines, with echocardiograms at baseline and first follow-up.
• Measurement of global longitudinal strain (GLS) and regional LS (apical, mid, basal) and calculation of percentage changes (Δ).
• Assessment of CTRCD development (LV ejection fraction <53% and >10% decrease from baseline) in 61 patients with further follow-up.

Main Results:

• Significant decreases in LVEF, GLS, and basal-LS were observed at first follow-up compared to baseline.
• 13% of patients developed CTRCD. Worse Δbasal-LS was significantly associated with CTRCD development.
• Kaplan-Meier analysis showed worse event-free survival in patients with a greater decrease in Δbasal-LS.

Conclusions:

• Basal-LS reduction precedes the development of CTRCD in patients undergoing anthracycline chemotherapy.
• Worsening basal-LS is a significant predictor of CTRCD.
• Monitoring basal-LS may aid in the early identification of patients at risk for chemotherapy-induced cardiotoxicity.