Evaluation Of Left Ventricular Function In Breast Cancer Patients Undergoing Anthracyclines By Left Ventricular Pressure-strain Loop Combined With Three-dimensional Speckle Tracking Imaging

Objective:Left ventricular pressure strain loop and three-dimensional speckle tracking imaging were used to evaluate the changes of left ventricular myocardial work and three-dimensional strain parameters in breast cancer patients receiving anthracycline-based chemotherapy,and to explore the value of left ventricular pressure strain loop and three-dimensional speckle tracking imaging in early clinical detection of chemotherapy-induced cardiac injury.Methods:Twenty-seven patients diagnosed with breast cancer by crude needle biopsy in the breast cancer group,Department of Breast Surgery and Oncology,the First Hospital attached to Jilin University,from December 2020 to July 2021,with left ventricular ejection fraction（LVEF）> 55% before chemotherapy,were selected and treated with anthracycline-based chemotherapy（epirubicin）.21 days for a cycle,there were a total of 6 cycles.Echocardiography was performed before chemotherapy（T0）and after 1-6 cycles of chemotherapy（T1-T6）,respectively.Meanwhile,27 female patients with matched age in routine physical examination were selected as control group.Normal two-dimensional,left ventricular work,normal three-dimensional and three-dimensional strain parameters were analyzed and the relevant indexes were obtained.Results:There were no statistically significant differences in clinical data,conventional two-dimensional echocardiography parameters,left ventricular strain,myocardial work parameters,ordinary threedimensional and three-dimensional strain parameters between the case group and the control group at stage T0（P > 0.05）.There was no significant difference in routine echocardiographic parameters between the patients after chemotherapy and before chemotherapy（P > 0.05）.Compared with T0,the differences of global constructive work（GCW）,3D GLS,3D global area strain（GAS）and 3D global radial strain（GRS）in T2,T3,T4,T5 and T6 were statistically significant（P < 0.05）,and were on the decline with the chemotherapy cycle.There were statistically significant differences in GLS,GWI and 3D GCS between T3、T4、T5、T6 and T0 in the case group（P < 0.05）,and the absolute value of GLS,GWI and 3D GCS decreased with the overall chemotherapy cycle.There were no significant differences in PSD,GWE,GWW,3D Twist and 3D Torsion between the two groups after chemotherapy and before chemotherapy（P > 0.05）.GWI,GCW were positively correlated with absolute value of 2D GLS.The absolute values of 2D GLS,GWI and GCW were negatively correlated with the cumulative dose.The absolute values of 3D GLS,GCS,GAS and GRS were negatively correlated with the cumulative dose.Conclusion:GWI and GCW in the left ventricular pressure strain loop can evaluate early cardiac damage in breast cancer chemotherapy patients from the perspective of myocardial work,and GCW is more sensitive than GWI.In the three-dimensional strain,GLS,GCS,GAS and GRS can all evaluate the early heart damage in patients with breast cancer chemotherapy,and GLS,GAS and GRS are more sensitive to GCS.All the above indicators provide new methods for the early assessment of heart damage in patients with breast cancer chemotherapy and suggest early clinical intervention.