The Value Of Two-Dimensional Speckle Tracking Technique In Clinical Study On The Effect Of Breast Cancer Chemotherapy On Cardiac Function Of Left Atrium And Right Ventricle

Objective:Two-dimensional speckle tracking technique（2D-STI）was used to study the effect of left atrium and right ventricle on cardiac function,and to evaluate whether this technique is more sensitive to detect cardiac injury.Methods : From October 2019 to June 2021,40 cases of breast cancer were diagnosed by breast ultrasound,breast puncture and pathology in Beihua University,the subjects,aged 30 to 60,were all female patients and were treated with epirubicin-based chemotherapy,TAC regimen（epirubicin + AMP + docetaxel）was used for 21-day chemotherapy cycle.Thirty healthy women of similar age and age were selected as control group.The control group and the chemotherapy group were analyzed by echocardiography and 2D-STI.Two cycles of chemotherapy and four cycles of chemotherapy were observed before chemotherapy,Left ventricular ejection fraction（LVEF）,end diastolic diameter（LVEDd）,early diastolic peak velocity（E）and late diastolic peak velocity（A）were measured,E/A ratio and left atrial anteroposterior diameter（LAD）were calculated,Right ventricular basal segment internal diameter（LAD1）,middle segment internal diameter（LAD2）,tricuspid annulus systolic blood flow velocity（S）,tricuspid free wall annular displacement（TAPSE）,left atrial storage phase strain（LASr）,left atrial channel strain（LAScd）,left atrial systolic phase strain（LASct）,right ventricular free wall basal segment strain（RVDa）,right ventricular free wall midwall strain（RVDb）,right ventricular free wall apical strain（RVDc）,The right ventricular free wall longitudinal strain（RVFWSL）and the right ventricular overall longitudinal strain（RVGLS）were analyzed.The relationship between the right ventricular free wall and overall strain and the dose of chemotherapy was analyzed by Spearman correlation analysis.Results:1.Compared with pre-chemotherapy,the volume of LAD increased and TAPSE decreased in the 4th cycle of chemotherapy（p < 0.05）.2.Compared with pre-chemotherapy,there was no significant difference in230 cases in control group and 40 cases in chemotherapy group after 2 and 4 cycles of chemotherapy（P > 0.05）,RVDa,RVFWSL and RVGLS decreased significantly after 4 cycles of chemotherapy（p < 0.05）,and RVDa,RVFWSL and RVGLS decreased significantly after 4 cycles of chemotherapy（p < 0.05）,there were significant differences（p < 0.05）in LASr,LAScd and RVDb decreased significantly after 4th cycle of chemotherapy（p < 0.05）.Conclusion:1.Anthracycline can affect the left atrium,and the strain of the left atrium decreases in varying degrees as the dose of chemotherapy increases.2.Anthracycline can affect the right ventricle,and as the dose of chemotherapy increases,the segmental and global strain of the free wall of the right ventricle decreases.3.Two dimensional speckle tracking technique can detect changes in the left and right atria more sensitively than conventional echocardiography,suggesting clinical treatment options.