Clinical Study Of Myocardial Integrated Backscatter Parameters In Assessment Of Cardiotoxity Of Patients Treated With Anthracycline

Objective To evaluate the clinical value of integrated backscatter(IBS)measurement in patients receiving cardiotoxic anthracycline for malignancy.Methods 83 patients during or after anthracycline chemotherapy for malignancy(ATC group) were studied, and 50 age- and gender-matched volunteers without cardiac involvement served as normal subjects(control group).Using a color Doppler ultrasound system(Agilent Sonos-5500),integrated backscatter (IBS) ,cyclic variation of IBS (CVIB),normalized IBS(IBS%)and normalized cyclic variation of IBS(CVIB%) were obtained at parasternal long-axis view. Standard echocardiographic measures of left ventricular function were also made.Results IBS changed periodically in normal subjects, and the value wasmaximal at end diastole and minimal at end systole.IBS in patients showed similar periodial change, but the amplitude of change was lower than that of normal subjects. IBS% was significantly higher while CVIB and CVIB% were lower in ATC group compared to those in the control group. No significant difference was found in systolic parameters of left ventricle and the thickening rate of the inter-ventricle septum and posterior wall whereas diastolic parameters were different between ATC group and control group. One or more diastolic variables(the ratio of E and A wave,the deceleration time of E wave and isovolumic relaxation times)were abnormal in 30 patients(36%) in ATC group. IBS parameters have no relationship with the culmulative dosage of ATC ,the amount of time since the first dose ,function parameters of left ventricle,the thickening rate of the inter-ventricle septum and left ventricle posterior wall.Conclusions Myocardial integrated backscatter parameters of patients treated with ATCis significantly different from normal subjects, and IBS parameters may be valuable to assess the early cardiotoxity of anthracycline.