Two-dimensional speckle tracking imaging and tissue Doppler imaging can predict subclinical left ventricular systolic and diastolic dysfunctions after chemotherapy for breast cancer.

Abstract

Objective: This research primarily analyzes the clinical application of two-dimensional speckle tracking imaging (2D-STI), real-time 3-dimensional echocardiography (RT-3DE), and tissue Doppler imaging (TDI) in evaluating left ventricular dysfunction associated with breast cancer (BC) chemotherapy-related cardiotoxicity.

Methods: First, we selected 106 BC patients who received treatment in The Affiliated Hospital of Chengde Medical University as the research group, all of whom underwent anthracycline-based chemotherapy; another 100 healthy subjects were chosen as the control group. Conventional ultrasound was employed to detect the mitral annular plane systolic excursion (MAPSE), mitral valve orifice early diastolic blood flow velocity (E), and left atrial volume index (LAVI) in the study subjects. 2D-STI was utilized to measure the global longitudinal strain (GLS) of the left ventricle, RT-3DE to measure left ventricular ejection fraction (LVEF), and TDI to measure the ratio of E to the average early diastolic mitral annulus velocity (E/e'), as well as systolic and early diastolic tissue velocities at the lateral wall of the mitral annulus and the ventricular septum (lateral s', septal s', lateral e', and septal e'). Left ventricular dysfunction was analyzed in both groups, and potential influencing factors were discussed.

Results: The data revealed markedly lower GLS, MAPSE, E, lateral e', and septal e' in the research group compared to the control group. GLS<15.02% and LVEF<53% were defined as left ventricular systolic dysfunction. In comparison with the control group, the GLS and LVEF abnormality rates were evidently higher in the research group. No left ventricular diastolic dysfunction was observed in patients in both groups. Additionally, the dose of anthracyclines was a potential influencing factor for left ventricular dysfunction.

Conclusions: 2D-STI and TDI have certain predictive implications for the occurrence of subclinical left ventricular systolic and diastolic dysfunctions after BC chemotherapy. Furthermore, high-dose anthracyclines might lead to left ventricular dysfunction.