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| Evaluation of left ventricular systolic function in breast cancer patients by layer-specific strain analysis |
| ZHANG Ge, LIU Chong, FU Xin, LI Hai-ru, ZHANG Lei, ZHAO Peng, DI Zhi-xin, TIAN Jia-wei |
| Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China |
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Abstract Objective: To evaluate the changes of left ventricular systolic function in breast cancer patients after sequential application of anthracyclines and trastuzumab chemotherapy by two-dimensional speckle tracking imaging(2D-STI) layer-specific strain analysis. Methods: Thirty patients diagnosed with breast cancer and sequential application of chemotherapy and anthracycline-trastuzumab were selected as the case group(group A), and 27 normal subjects were selected as the control group(group B). The 2D images of patients in group A were collected and stored before chemotherapy(T0 phase), after 4 cycles of anthracycline(T1 phase) and after sequential 17 cycles of trastuzumab(T2 phase). The conventional echocardiographic parameters and the global longitudinal strain(GLS) in each myocardial layer were measured and compared. Results: ①There were no significant differences in the conventional echocardiographic parameters and GLS between the group A in the T0 phase and group B(P>0.05). ②There was no significant difference in the LVEF between T1, T2 and T0 phases in the group A(P>0.05). In the T1 phase, the endocardial GLS was significantly lower than that in the T0 phase. The endocardial and mid-myocardial GLS in the T2 phase were significantly lower than those in the T0 phase, and the differences were statistically significant(P<0.01). ③There was no significant difference in LVEF between the T2 and T1 phases in group A. The endocardial and midmyocardial GLS in the T2 phase were significantly lower than those in the T1 phase. The difference was statistically significant(P<0.05). Conclusion: The 2D-STI layer-specific strain analysis could accurately evaluate the left ventricular systolic function by analyzing the GLS in each myocardial layer, so it might be used to reflect the subclinical cardiotoxicity of patients after sequential application of anthracyclines and trastuzumab.
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Received: 21 December 2019
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