Evaluative Value Of Two-dimensional Speckle Tracking On Left Ventricular Systolic Function In Patients Of Breast Cancer Adopted Anthracycline Chemotherapy Combined With Hypertension

Objective: To investigate the application value of two-dimensional speckle tracking imaging technology(2D-STI)in the evaluation of left ventricular myocardial systolic function in patients of breast cancer adopted anthracycline chemotherapy combined with hypertension.Methods: From March 2018 to November 2019,57 cases of female patients with breast cancer confirmed by pathology in our hospital and requiring neoadjuvant chemotherapy were selected.According to the combination of hypertension,24 cases were divided into hypertension group and 33 cases were divided into non-hypertension group.All chemotherapy regiments were AC(doxorubicin + cyclophosphamide)/EC(epirubicin+cyclophosphamide).The duration of chemotherapy was 4cycles,one cycle was 21 days.All patients underwent routine echocardiography before chemotherapy and 1-2 weeks after completion of neoadjuvant chemotherapy,and standard dynamic images were collected for storage.The image frame rate was > 60 Hz.Routine parameters [ECG results,cardiac troponin T(CTn T)value,brain natriuretic peptide(BNP)value,left ventricular ejection fraction(LVEF),valve reflux,and left ventricular end-diastolic volume(LVEDV),left ventricular endsystolic volume(LVESV)] and myocardial strain parameters were recorded,and SPSS statistical software was used to analyze the data of each group.Analysis methods included: ?before chemotherapy comparison of age,height,weight,heart rate,chemotherapy dose,LVEF,LVEDV and LVESV between the hypertensive group and the non-hypertensive group.?conventional parameters before and after chemotherapy were compared in the two groups.?comparison of conventional parameters between the two groups after chemotherapy.?the myocardial strain parameters before and after chemotherapy were compared in the two groups.?the significantly reduced myocardial strain parameters in both groups were extracted,and the difference value(?)between the two groups before and after chemotherapy was compared.?referring to the nonhypertensive group,the left ventricular myocardial strain parameters of the hypertensive group were used to predict the left ventricular myocardial dysfunction after chemotherapy in patients with breast cancer aggravated by hypertension.Results :(1)there were no statistically significant differences in age,chemotherapy dose,height,weight,heart rate,LVEF,LVEDV and LVESV between the hypertensive group and the non-hypertensive group before chemotherapy(p>0.05).(2)there were statistically significant differences in ECG abnormal rate,CTn T abnormal rate,valve reflux rate and LVEF value between the hypertensive group and the non-hypertensive group(p< 0.05).(3)after chemotherapy,there were no statistically significant differences in the rate of newly added ECG abnormalities,the rate of newly added abnormal CTn T,the rate of newly added valve regurgitation and the LVEF value between the hypertensive group and the non-hypertensive group(p>0.05).(4)the myocardial strain parameters of the hypertensive group and the non-hypertensive group decreased before and after chemotherapy(GLS,GLSAP2,GLSAP3,GLSAP4,GRS,RMS,RBS,GCS,CMS,CBS)p<0.05,the difference was statistically significant.There was no significant difference in RAS and CAS(p>0.05).(5)the parameters with significant differences after chemotherapy in(4)were analyzed,and the differences between the two groups in ?GLS,?GLSAP2,?GLSAP3,?GLSAP4,?RBS,?GCS,?CBS were statistically significant(p<0.05).(6)the left ventricular myocardial strain parameters GLS,GLSAP2,GLSAP3,GLSAP4,RBS,GCS,CBS in the hypertension group all had certain predictive value for left ventricular myocardial dysfunction in the patients with hypertension and breast cancer chemotherapy,of which GLS had the highest predictive value,with the area under the curve at 0.751,the threshold value at-15.95%,the sensitivity at 0.87,and the specificity at 0.694.Conclusions:(1)with or without hypertension,breast cancer patients with anthracyclines have impaired left ventricular myocardial systolic function after chemotherapy.(2)breast cancer patients with hypertension were more severely impaired in left ventricular myocardial systolic function after anthracyclines chemotherapy.(3)the effect of hypertension on left ventricular myocardial systolic function in patients with anthracyclines chemotherapy for breast cancer can be evaluated by spackle tracking technique.