Ultrasound Speckle Tracking Imaging Of Left Ventricular Geometry And Function In Breast Cancer Anthracycline Chemotherapy

Purpose Detection of left ventricular geometry and function in breast cancer anthracycline chemotherapy patients by ultrasound speckle tracking imaging (STI) provide a valuable early clinical diagnosis and treatment information of anthracycline chemotherapy drug-induced cardiotoxicity.Methods60selected breast cancer patients were all female, accepted surgical treatment.They were divided into two groups of TAC and AC-T according to different postoperativechemotherapy[T(Taxotere)-Docetaxelchemotherapydrugs;A(adriamycin)-Doxor ubicin chemotherapy drugs;C(Cyclophosphamide)-cyclophosphamide chemotherapy drugs]. The TAC group of30patients, aged43.6±7.71years, used of6cycles of TAC combined chemotherapy,21days for a period. The AC-T group of30patients, aged46.4±9.41years, used of8cycles of AC-T sequential chemotherapy,21days for a period. Two-dimensional echocardiography was used to detect the left ventricular geometry parameters [left ventricular end-diastolic diameter (LVDd), end-diastolic interventricular septal thickness(IVSTd), end-diastolic left ventricular posterior wall thickness(LVPWTd)],global left ventricular systolic function parameter [left ventricular ejection fraction (LVEF)] and mitral flow E/A in the control group, in the TAC group at the end of3cycles of chemotherapy, at the end of6cycles of chemotherapy and in the AC-T group at the end of4cycles of chemotherapy, at the end of8cycles of chemotherapy; respectively. Two-dimensional ultrasound STI was used to detect left ventricular regional systolic function parameters [myocardial velocities (MV), circumferential strain rate (CSR), radial strain rate (RSR), angular velocity (AV), angle excursion (AE)] and left ventricular regional diastolic function parameters [unwinding rate(Untw R), half time of untwisting (HTU)] in the control group, in the TAC group at the end of3cycles of chemotherapy, at the end of6cycles of chemotherapy and in the AC-T group at the end of4cycles of chemotherapy, at the end of8cycles of chemotherapy, respectively, and compared the parameters in the TAC group and in the AC-T group before chemotherapy with those in the control group, the parameters in the TAC group at the end of3cycles of chemotherapy, at the end of6cycles of chemotherapy with those of before chemotherapy, parameters in the AC-T group at the end of4cycles of chemotherapy, at the end of8cycles of chemotherapy with those of before chemotherapy.Results1.The parameters of left ventricular geometry and function in the TAC group and in the AC-T group before chemotherapy were not significantly different compared with the control group (P>0.05, all).2.Compared with the parameters of the same group before chemotherapy, left ventricular geometry parameters LVDd, IVSTd, LVPWTd, global left ventricular systolic function parameter LVEF and mitral flow E/A in the TAC group at the end of3cycles of chemotherapy, at the end of6cycles of chemotherapy and in the AC-T group at the end of4cycles of chemotherapy, at the end of8cycles of chemotherapy were not significantly different (P>0.05, all).3.Compared with the parameters before chemotherapy in the TAC group, only the left ventricular regional diastolic function parameter Untw R reduced at the end of3cycles of chemotherapy with significant difference (P<0.05). all the left ventricular regional systolic function parameters MV, CSR, RSR, AV, AE and the left ventricular regional diastolic function parameter HTU were not significantly different (P>0.05, all);4. Compared with the parameters before chemotherapy in the TAC group, all the left ventricular regional systolic function parameters MV, CSR, RSR, AV, AE were reduced, the left ventricular regional diastolic function parameter Untw R reduced, HTU extended at the end of6cycles of chemotherapy with significant differences (P<0.05, all).5.Compared with the parameters before chemotherapy in the AC-T group, the left ventricular regional diastolic function parameter Untw R reduced, HTU extended at the end of4cycles of chemotherapy with significant differences (P<0.05, respectively), all the left ventricular regional systolic function parameters MV, CSR, RSR, AV, AE were not significantly different (P>0.05, all);6. Compared with the parameters before chemotherapy in the TAC group, the left ventricular regional systolic function parameters MV, AV, AE were reduced, the left ventricular regional diastolic function parameter Untw R reduced, HTU extended at the end of8cycles of chemotherapy with significant differences (.P<0.05, all), the left ventricular regional systolic function parameters CSR, RSR were not significantly different (P>0.05, respectively).Conclusion1.The cardiac toxicity of anthracycline chemotherapy drugs are cumulative, the cardiac side effects become more apparent with the the dose of drugs increased.2.The cardiac toxic effects of anthracycline chemotherapy drugs mainly induce cardiac dysfunction, left ventricular regional myocardial systolic and diastolic dysfunction occurs when there is no change of global left ventricular systolic function, and left ventricular regional diastolic dysfunction earlier than regional systolic dysfunction. Ultrasound STI could detect regional myocardial damage early in anthracycline chemotherapy patients, and could provide valuable information for early clinical assessment of cardiac toxicity, timely treatment and prognosis.