Velocity Vector Imaging Assessment With Early Adriamycin-induced Myocardial Damage

Objective:Breast cancer is one of the malignant tumors. Anthracyclines play an important role in combination chemotherapeutic agents for breast cancer. However, the therapeutic benefit of these agents has been limited by their myocardial toxicity which is primarily related to the cumulative dose of the drug administered. In most circumstances, which may result in congestive heart failure. So, early detection of myocardial damage might enable implementation of preventive measures that could reduce the likelihood of congestive heart failure late in life. Recently developed new technique——Velocity Vector Imaging(VVI)can conquer the drag of surrounding myocardial and interference of the global heart movement and estimate exactly regional myocardium function.Previously reseaches in and out about the subclinical stage of anthracycline-induced myocardial damage using velocity vector imaging are rare.The aims of this study are to investigate the regional longitudinal systolic and diastolic function of left ventricular in patients treated by anthracyclines therapy by VVI and to discuss the important clinical value of VVI in quantitatively evaluating regional longitudinal function.Subjects and method:We examined respectively30patients with breast cancer treated by anthracyclines chemotherapy and30normal control persons. They were matched with for sex and age. All patients who had not been treated with anthracyclines therapy and had not cardiovascular history. All persons were examined by echocardiograph and examinations of30patients with anthracycline chemotherapy were repeated after every chemotherapy. Dynamic imaging of apical long axis and four-chambe two-chambe view were obtained in all subjects, then the longitudinal systolic and diatolic period parameters were measured in all subjects respectively, such as:systolic max velocity(Vs)、systolic max strain(SS),systolic max strain rate (SSR),diastolic max velocity(Vd),diastolic max strain rate(DSR).The parameters were analysed between these groups.Results:Compared to healthy control, there were no significant change in every parameters of baseline before first period in30breast cancer patients (P>0.05)Compared to baseline, conventional echocardiography parameters, including LV、LA、EF、FS and E/A didn’t change significantly at total of dose225mg/m2(P>0.05).But, After second chemotherapies cycle,DSR was lower in every segments, the Vd were lower mainly in free wall (P<0.05),the Vd didn’t change significantly in septum wall (P>0.05). After third chemotherapies cycle, the Vd、DSR and SSR decreased significantly in all segments (P<0.05).the Vs and SS didn’t change significantly (P>0.05)Conclusion:ⅤⅥ can monitor the anthracycline cardiotoxicity and earlier than Echocardiograph. Also, VVI may have important clinical value for early detection of anthracycline cardiotoxicity。...