Evaluation Of Left Ventricular Function Changes In Patients After Radiotherapy And Chemotherapy By Speckle Tracking Imaging

Part one Evaluation of left Ventricular Function in Breast Cancer Patients Treated with Anthracycline by Layed-specific Two-dimensional Speckle Tracking ImagingObjective: To investigate the value of layed-specific two-dimensional speckle tracking imaging( 2D-STI) in evaluating changes of the left ventricular function in breast cancer patients treated with Anthracycline.Methods: A total of 35 patients treated with Anthracycline in our hospital were enrolled in the study,All patients underwent ultrasound examination before and after Anthracycline treatment respectively.2D strain software was used to calculate the two groups of left ventricular layered global circumferential strain(endo-GCS, epi-GCS, mid-GCS) and the global radial strain(GRS) at three levels of the shorts axis views(mitral valve,papillary muscle and cardiac apex view),the layered global longitudinal strain(endo-GLS, epi-GLS, mid-GLS)at the long axis view(apical 3-chamber view, apical 4-chamber view and apical 2-chamber view). The full-volume image of apical four-chamber was collecting simultaneously,the software was applied to acquire the data including left ventricular end diastolic volume(EDV), left ventricular end systolic volume(ESV), left ventricular stroke volume(LVSV) and left ventricular ejection fraction(LVEF) 、 left ventricular mass(LVMASS). Then all indexes before and after chemotherapy were compared.Results: 1. There were no significant differences in EDV、ESV、LVEF、LVSV、VMASS before and after radiotherapy.2. Endo-GLS,Epi-GLS and Mid-GLS in breast cancer patients after chemotherapy had significantly decreased(-20.2±3.3%、-17.7±2.8%、-15.4±2.4% vs-22.0±2.6%、-19.3±2.3%、-16.9±2.1% respectively,all P <0.05). Endo-GCS, Epi-GCS, Mid-GCS and GRS in breast cancer patients after chemotherapy has no statistical significant changes.Conclusions: The layered global longitudinal systolic function have damaged in breast cancer patients after chemotherapy.2D-STI can detect subtle left ventricular global systolic dysfunction.Part two Evaluation of Cardiac Ventricular Function Changes in cancer Patients Treated with thoracic radiotherapy by Three-dimensional Speckle Tracking Imaging.Objective: To evaluate the value of three-dimensional speckle tracking technique(3D-STI) in evaluating change of the left ventricular systolic function after thoracic radiotherapy.Methods: A total of 35 cancer patients treated with thoracic radiotherapy in our hospital were enrolled in the study, and the heart was exposed. All patients underwent ultrasound examination before and after radiotherapy respectively. After collecting full-volume image of apical four-chamber view,the Echo-Pac 113 was applied to acquire the data including left ventricular global area peak systolic strain(GAS),global circumferential peak systolic strain(GCS),global longitudinal peak systolic strain(GLS),global radial peak systolic strain(GRS), left ventricular mass( LVMASS),left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV), left ventricular stroke volume(LVSV) and left ventricular ejection fraction(LVEF),etc. Then all indexes before and after radiotherapy were compared.Results: 1. There were no significant differences in EDV、ESV、LVEF、LVSV 、 LVMASS before and after radiotherapy.2.After radiotherapy, GCS,GAS and GRS were all decreased before radiotherapy(-12.5±3.2%、-23.8±4.8% 、-34.4±8.2%vs-14.1±3.5% 、-25.8±4.8% 、-38.0±8.7%,respectively,all P <0.05). There were no significant differences in GLS before and after radiotherapy.Conclusions: The circumferential, area and radial systolic function have different degrees of injury after radiotherapy. 3D-STI can detect subtle left ventricular global systolic dysfunction after thoracic radiotherapy.