Global Longitudinal Strain as a Surveillance Tool in Hematologic Cancer-Related Cardiotoxicity

Area of Science:

• Cardio-oncology
• Cardiovascular imaging
• Hematologic malignancies

Background:

• Cancer therapies improve survival but increase cardiac dysfunction risk.
• Early cardiotoxicity detection is crucial for preventing irreversible myocardial injury.
• Conventional measures like ejection fraction often detect damage late.

Purpose of the Study:

• Review the role of Global Longitudinal Strain (GLS) in monitoring cancer therapy-related cardiac dysfunction (CTRCD).
• Summarize the pathophysiological basis of chemotherapy-induced myocardial injury.
• Examine GLS's predictive and monitoring capabilities in hematologic malignancy patients.

Main Methods:

• Speckle-tracking echocardiography to derive GLS.
• Review of existing literature on GLS in cardio-oncology.
• Analysis of GLS's performance in risk stratification and outcome prediction.

Main Results:

• GLS detects subclinical myocardial dysfunction earlier than ejection fraction.
• GLS demonstrates prognostic value across various cancer therapies (chemotherapy, HSCT, immunotherapy).
• GLS integration with biomarkers enhances early detection and risk stratification.

Conclusions:

• GLS is a sensitive tool for early cardiotoxicity surveillance in hematologic malignancy patients.
• Despite limitations, GLS is becoming a guideline-recommended surveillance strategy.
• GLS aids in managing cardiac risks associated with cancer treatments.