| Objective Breast cancer is a solid tumor with a high degree of malignancy among Chinese female patients and is also the most malignant tumor among female patients in foreign countries.The current comprehensive surgical treatment of chemotherapy combined with the program has been widely used in clinical and significant effect,which can effectively improve the quality of life of patients and prolong their lives.Anthracyclines(ATC)have far-reaching effects on the structure and function of the heart,which can lead to congestive heart failure and cardiomyopathy as the cumulative dose increases and over time.Early detection of low doses of anthracyclines may be an effective strategy to prevent the dysfunction of subclinical left ventricular(LV).Three-dimensional speckle tracking imaging(3D-STI)is based on 2D-STI(2D-STI)combined with real-time three-dimensional echocardiography Tracking,which is a all-round display of its trajectory,thus the heart can be more accurate assessment of the subject's overall and overall function.The purpose of this study was to analyze area strain using 3D-STI techniques for the detection of anthracycline-mediated cardiotoxicity.Methods Eighty-three cases of newly diagnosed female breast cancer patients(aged21-67 years)with obvious pathological classification and anthracycline chemotherapy were collected.All patients underwent epirubicin-based anthracycline(Epirubicin+cyclophosphamide)were divided into group A(39 cases after left-sided surgery)and group B(44 cases after right-sided operation),respectively.The cumulative dose of epirubicin was 0,180 mg/m~2,360mg/m~2 were performed conventional and three-dimensional echocardiography.Meanwhile,the biochemical indexes of venous blood in fasting state were extracted and compared with the parameters of different chemotherapy stages,and compared the difference between the two groups of parameters A and B,to explore whether the two groups of patients changes or not in cardiac function after chemotherapy,if not,the two groups merged into a whole ROC curve analysis of the overall three-dimensional strain parameters to assess the overall left ventricular The clinical value of systolic function.Results All the subjects had no significant difference in routine data HR,LVEF,LVESVandLVEDV when cumulative doses of epirubicin were 0,180mg/m2 and360mg/m2(all P>0.05).The levels of cTnT-hs in the three chemotherapy cycles and six cycles of chemotherapy were higher than those before chemotherapy,but in the normal range,the difference was statistically significant(P<0.05).The left ventricular total area strain(GAS),total long axis strain(GLS)in group A and group B were significantly lower than those before chemotherapy,which is compared to those after chemotherapy(P<0.05).There was no significant change in GCS compared with that before chemotherapy.The late stage of chemotherapy was significantly lower than that before chemotherapy(P<0.05),while there was no significant change of GRS in the whole course of chemotherapy(P>0.05).There was no significant difference between A and B groups(P>0.05).After A group and B group were integrated,the area under the ROC curve of the whole GAS was 0.923,with the cut-off value of-30.5%,the sensitivity 88.1%and specificity of 83.6%.Conclusion 3D-STI area strain parameter are of high specificity and sensitivity,which is an effective non-invasive method for the early detection of subclinical anthracycline cardiotoxicity.and cardiac function has no significant changes after chemotherapy on left and right breast cancer. |
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