Early Detection of Myocardial Dysfunction by Two-Dimensional Speckle Tracking Echocardiography and Myocardial Work in...

We aimed to evaluate the myocardial dyssynchrony in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) by two-dimensional (2D) speckle tracking echocardiography (STE) and myocardial work (MW).

This cross-sectional study included 40 patients with GEP-NENs (45.00% men; mean age, 51.48 ± 15.22 years) and 24 age- and gender-matched healthy subjects (58.33% men; mean age, 46.17 ± 11.12 years) who underwent standard echocardiography. Left ventricular (LV) and right ventricular (RV) strain measurements were assessed by 2D-STE. Post-systolic index (PSI) was calculated as [(post-systolic peak longitudinal strain-end-systolic strain)/end-systolic strain] × 100%. LV mechanical dispersion (MD) was measured as the standard deviation of time to peak negative strain (TTP). MW indices were measured based on pressure-strain loop (PSL) analysis. The cases were grouped based on treatment therapy.

Compared with healthy controls, patients with GEP-NENs had impaired global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global work efficiency (GWE), RV global strain (RV-GS) and RV free wall strain (RV-FWS) (p < 0.05). Increased PSI_max, MD, and global wasted work (GWW) were also observed in patients with GEP-NENs (p < 0.05). GLS was independently associated with male gender (β = 0.443, p = 0.003) and hypertension (β = -0.418, p = 0.005). MD was positively correlated with the treatment of surgery (β = 0.333, p = 0.036). PSI_max was positively correlated with the duration of disease (β = 0.517, p = 0.001). GWI was positively correlated with the treatment of targeted therapy (β = -0.355, p = 0.025).

Assessment of 2D-STE and PSL analysis provides novel information to early detect LV and RV subclinical mechanical dyssynchrony in patients with GEP-NENs.