Evaluating The Effect Of Anthracycline On Right Ventricle Function By Echocardiography

Objective:To explore the value of echocardiography in evaluating the effect of anthracycline on function of patients with multiple myeloma.Furthermore explore more accurate and sensitive parameters for assessing changes in right ventricular function after chemotherapy.Methods:A total of 41 patients(LVEF ? 55 %)with multiple myeloma who received anthracycline(ATC)treatment were enrolled.Each patient underwent transthoracic echocardiographic examination before chemotherapy as well as after two,four and six cycles of ATC remedy.Right ventricular(RV)end—diastolic area(EDA),end—systolic area(ESA),Right ventricular fractional area change(RVFAC),and early or late diastolic myocardial velocities of RV were calculated,Tissue Doppler imaging(TDI)measurements of systolic,early or late diastolic myocardial velocities of RV free wall at tricuspid annuals,E/Em,tricuspid annular plane systolic excursion(TAPSE),and Tei index of right or left ventricle were also analyzed.Two-dimensional speckle tracking echocardiography(2DSTE)was conducted to evaluate RV global longitudinal strain(GLS),20 cases of healthy volunteers were selected as the normal.Results:The RVGLS and E/Em changed significantly after cures of treatment compared withthose at baseline(P<0.05),The RVGLS were decreased as the chemotherapy cycle.At the end of the therapy after six cycles of ATC treatment,TAPSE decreased significantly till six cures of treatment compared with those at baseline(P<0.05),The RVGLS were negatively correlated to cumulative anthracycline dose,the correlation coefficient were-0.799,respectively(P <0.001).The area under the ROC curve of E/Em was 0.995(P =0.000),If 5.22 was selected as the diagnosis cut-off point,the sensitivity was 93.7%,and the specificity was 100%.Conclusion:RVGLS,E/Em and TAPSE are more sensitive indetecting abnormalities of right ventricular function.