Evaluation Of Left Ventricular Transmural Mechanics After Anthracycline Chemotherapy By Speckle Tracking Imaging

Objective:Evaluation of left ventricular transmural mechanics changes breast cancer treated with thracycline chemotherapy by Two-dimensional speckle tracking imaging (2D-STI).Methods:46 breast cancer treated with anthracycline chemotherapy, mean age (50.8±10.4) rears.Echocardiography were performed on all subjects before and at 1 and 3 and 6 (?)thracycline chemotherapeutic cycle.Collection and storage of the mitral valve level, apillary muscle level,apical the level short-axis view and apical four-chamber, hree-chamber,two-chamber long-axis view of the dynamic image.Application biplane Simpson method to measure the left ventricular ejection fraction (LVEF).Qlab strain software to analyze and get the various segments of left ventricular systolic endocardial, ;picardial,global myocardial longitudinal strain,radial strain,circumferential strain, calculate the mean 18 myocardial segments of these parameter and transmural strain value. Comparison conventional echocardiographic parameters and strain-related parameters efore and after chemotherapy.Results:①After the sixth cycle of anthracycline treatment,9 patients (16.4%) had developed anthracycline-induced cardiotoxicity(a decrease in EF of 10% to an EF of <55%),and 37 atients (80.4%%) did not fulfill the criteria for cardiotoxicity.②No statistical difference in conventional echocardiography parameters showed before and anthracycline chemotherapy 1,3 cycle (P>0.05); In comparison with baseline cases,left ventricular ejection fraction (LVEF)..fractional shortening (FS), E/A, E/e diastolic function parameters) deteriorated significantly,the difference was statistically significant (P<0.05).③In comparison with baseline cases,after 3,6 cycles of chemotherapy left ventricular eak longitudinal strain (GLS),subendocardial peak longitudinal strain (LS-endo),the peak ongitudinal strain epicardial (LS-epi), longitudinal strain transmural gradient (TMSG-LS) educed,the difference was statistically significant (P<0.01).In comparison with baseline :ases,after six cycles of chemotherapy left ventricular peak radial strain (GRS), ;ubendocardial peak radial strain (RS-endo),radial peak strain epicardial (RS-epi) significantly reduced,the difference was statistically significant (P<0.01). RS-endo reduce arger than RS-epi,TMSG-RS significantly reduced,the difference was statistically significant.④ROC curve results showed that GLS,LS-endo, LS-epi,TMSG-LS accuracy letection of anthracycline cardiotoxicity,area under the curve TMSG-LS> LS-endo> GLS> S-epi, respectively 0.823,0.802,0.791 and 0.739.Conclusion:Left Ventricular Mechanics breast cancer after anthracycline chemotherapy change :an early detect of anthracycline chemotherapy-induced cardiotoxicity,for the clinical pplication of early intervention has some value.