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Updated: Jun 14, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Investigation of the effect of intravitreal bevacizumab treatment on left heart function using speckle tracking
Mehmet Şahinbaş1, İdris Buğra Çerik2, Duygu Yalınbaş Yeter3
1Department of Cardiology, Sivas Numune Hospital, Sivas, Turkey.
Introduction And Objectives:
Vascular endothelial growth factor (VEGF) inhibitors are widely used in oncology and ophthalmology. Although these agents have been shown to increase the risk of cardiovascular events in systemic use, the effect of local applications is unclear. In our study, we aimed to investigate the effects of anti-VEGF agents on left heart functions after intravitreal injection using speckle tracking echocardiography.
Methods:
In this prospectively designed study, 44 patients who were going to start intravitreal anti-VEGF treatment were included in the study. Patients were evaluated with speckle tracking echocardiography before the first anti-VEGF administration and at three months of anti-VEGF treatment.
Results:
Global longitudinal strain (GLS) values at three months were lower in the patients who participated in the study and this was statistically significant (-18.77±2.17, -18.60±2.01, p=0.001). Also, there was a statistically significant decrease in the mean values of GLS (GLS4CH) obtained from apical four space image, GLS (GLSAPLAX) obtained from apical long axis image and GLS (GLS2CH) obtained from apical 2 space image at month 0 and month 3 (-19.08±2.39, -18.93±2.26, p=0.004; -18.81±2.29, -18.60±2.12, p=0.001; -18.44±2.31, -18.27±2.12, p=0.013, respectively).
Conclusion:
The slight decrease in GLS in our study suggests that the use of intravitreal anti-VEGF agents may have cardiac effects.
Insights
Intravitreal anti-VEGF agents may impact heart function. This study found a statistically significant decrease in global longitudinal strain (GLS) after three months of treatment, suggesting potential cardiac effects from these localized treatments.
Area of Science:
- Cardiology
- Ophthalmology
- Pharmacology
Background:
- Vascular endothelial growth factor (VEGF) inhibitors are used systemically in oncology and ophthalmology.
- Systemic anti-VEGF use is linked to cardiovascular risks, but local application effects are unknown.
- Investigating cardiac effects of intravitreal anti-VEGF is crucial.
Purpose of the Study:
- To evaluate the impact of intravitreal anti-VEGF agents on left heart function.
- To assess changes in cardiac mechanics using speckle tracking echocardiography.
- To determine if local anti-VEGF therapy affects cardiac performance.
Main Methods:
- Prospective study including 44 patients undergoing intravitreal anti-VEGF treatment.
- Speckle tracking echocardiography performed before treatment and at three months.
- Analysis of global longitudinal strain (GLS) and regional GLS values.
Main Results:
- A statistically significant decrease in global longitudinal strain (GLS) was observed at three months.
- Significant reductions in GLS were noted in apical four-chamber, apical long-axis, and apical two-chamber views.
- Mean GLS values decreased significantly from baseline to three months post-treatment.
Conclusions:
- Intravitreal anti-VEGF agents may induce subtle cardiac effects.
- A slight decrease in GLS suggests potential cardiac alterations after local anti-VEGF therapy.
- Further research is warranted to understand the clinical significance of these findings.
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