Evaluation Of Left Ventricular Dysfunction In Breast Cancer Patients Exposed To Chemotherapy With Vector Flow Mapping

Objective To assess the left ventricular energy loss and circulation strength of the breast cancer patients exposed to chemotherapy using vector flow mapping(VFM),and to find a new indicator to evaluate the early abnormalities of left ventricular dysfunction caused by chemotherapy.Method By using self-control study method,43 patients were enrolled.After mastectomy,chemotherapeutics was given as follows: Docetaxel(75mg/m2),Epirubicin(90mg/m2)and Cyclophosphamide(500mg/m2)per cycle for total six cycles.All patients were followed up 7 times,including preoperative baseline and every cycle of chemotherapy,named group P0,group 1 to 6.HITACHI ALOKA Prosound F75 Color Doppler ultrasound system were used to acquire the interventricular septum(IVSd),left ventricular posterior wall(LVPW),left ventricular end diastolic diameter(LVDd),left ventricular ejection fraction(LVEF,Simpon's),E/A ratio,e/a ratio,E/e ratio and Tei index.Get LV VFM parameters: energy loss(EL),circulation strength(CIR)in early diastolic phase(EDC),late diastolic phase(LDC),isovolumic contraction(IVC),rapid ejection period(REP).SPSS 22.0 was used.ALL parameters between every cycle were examined by Mauchly's Test of Sphericity.The correlation of the VFM parameters and left ventricular function were analyzed using Spearman correlation analysis.Receiver operating characteristic curve(ROC)was used to compare the different diagnostic efficacy among parameters.P<0.05 was considered statistic significant for all the analyses.Result E/e was bigger in groups P1 to P6 than that in group P0(P<0.05).Tei index was bigger in groups P4 to P6 than that in group P0(P<0.05).The EL of EDC,LDC,IVC and REP was reduced from the 4th,2nd,4th and 5th cycles of chemotherapy(P<0.05).The CIR of EDC,LDC and IVC increased from the 5th cycle,the 2nd cycle and the 6th cycle of chemotherapy(P<0.05),and the REP_CIR did not change(P>0.05).The ROC curve analysis showed the AUC of each index increased gradually with the chemotherapy.Conclusion In this study,the patients exposed to chemotherapy even without obvious clinical manifestations of cardiac dysfunction and decreased LVEF at the early stage of chemotherapy cycles suffer from significant reduced EL and CIR,suggesting that these innovative parameters could response to left ventricular dysfunction earlier and might promise a higher diagnostic potential for cardiac chemotherapeutic damages.These indicators could be used to quantitatively evaluate LV dysfunctioncontinuously for dynamic monitor of cardiac dysfunction in breast cancer patients after anthracycline chemotherapy at early stages.