Comprehensive Evaluation of Cancer Treatment-Related Cardiac Dysfunction by Ultrasound Myocardial Strain: A Network...

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Anticancer treatments are vital but can cause cardiac dysfunction.
• Myocardial strain is a sensitive indicator of early cardiac damage from cancer therapies.

Purpose of the Study:

• To compare and rank various anticancer regimens based on their cardiac impact.
• To evaluate the effectiveness of cardioprotective strategies in mitigating treatment-related cardiac dysfunction.

Main Methods:

• Bayesian network meta-analysis of 33 studies involving 4613 subjects.
• Collection and analysis of global longitudinal strain (GLS) and other myocardial strain parameters at multiple time points (T0, T3, T6, T12).
• Comparison of weight mean differences (WMD) with 95% confidence intervals (CI) to assess treatment effects.

Main Results:

• Anthracycline-based chemotherapy (ANT), trastuzumab, paclitaxel, and radiotherapy (RT) significantly reduced GLS and global circumferential strain.
• ANT combined with RT showed a greater decrease in GLS at 12 months compared to ANT alone.
• Cardioprotective regimens (e.g., ANT+bisoprolol+ACE inhibitors, ANT+rosuvastatin) improved GLS at 12 months compared to ANT alone.

Conclusions:

• Specific anticancer regimens, particularly ANT+RT, negatively impact GLS.
• Combining standard anticancer treatments with cardioprotective drugs can preserve or improve cardiac function.
• Findings aid clinicians in selecting optimal, heart-sparing cancer treatment strategies.