Evaluation Of Cardiac Function In Breast Cancer Patients After Adjuvant Therapy By Two-Dimensional Speckle Tracking Technology

Objective:To explore the value of conventional echocardiography and two-dimensional speckle tracking strain parameters in assessing cardiac damage associated with breast cancer radiotherapy and chemotherapy,and to evaluate the diagnostic performance of two-dimensional speckle tracking strain parameters in predicting breast cancer treatment-induced cardiotoxicity,with a view to early identification of cardiac Injury,early preventive measures,and improved treatment regimens can reduce heart-related mortality during and after treatment,and improve patient outcomes and quality of life.Methods: A total of 56 female patients,aged 53.09±9.97(28-75)years,who were diagnosed with left breast cancer in the Third Xiangya Hospital of Central South University from July 2020 to October 2021 were selected,and the general clinical data of the patients were collected..The patients were divided into AC group(anthracycline chemotherapy group),AC+RT group(anthracycline chemotherapy+radiotherapy group)and RT group(radiotherapy group)according to different postoperative adjuvant treatment regimens.Routine two-dimensional echocardiography and 2D-STI were performed,and images were collected for subsequent off-line analysis.The parameters of left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic volume(LVEDV),and left ventricular end-diastolic volume(LVEDV)were compared between the three groups before and after adjuvant therapy.End-systolic volume(LVESV)and left ventricular ejection fraction(LVEF),and then compared the 2D-STI measurement parameters of left ventricular global longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain before and after adjuvant therapy in the three groups of patients.(GRS),to evaluate whether the cardiac function parameters of the patients in each group decreased after adjuvant therapy;compare the differences of LVEF,GLS and GCS before and after adjuvant therapy in the three groups of patients,and evaluate the degree of cardiac function changes in the three groups of patients,and the cardiac function of different adjuvant therapy programs.Whether the changes were different;the diagnostic power of GLS and GCS for predicting cardiotoxicity in three groups of patients was assessed using receiver characteristic curves.Results: According to the exclusion criteria,a total of 50 women with left-sided breast cancer were included in this study for data analysis.4 patients in the AC group showed cardiac injury,6 patients in the AC+RT group showed cardiac injury,and 3 patients in the RT group showed cardiac injury.There was no significant difference in the parameters of LVEDV and LVESV measured by conventional ultrasound Simpson biplane method before and after adjuvant therapy(P>0.05),and the parameters of LVEF measured by conventional ultrasound Simpson biplane method after adjuvant therapy were significantly higher than those at baseline.2D-STI measurement parameters GRS before and after adjuvant treatment had no statistical difference between the three groups(P>0.05),2D-STI measurement parameters GLS and GCS after adjuvant treatment were significantly decreased compared with the baseline;three There were significant changes in LVEF,GLS and GCS in the three groups before and after adjuvant therapy,but there was no significant difference in the difference between the three groups of patients in the difference of conventional ultrasound measurement parameters before and after treatment(P>0.05).The three groups of patients were AC+RT group,RT group and AC group,the difference was statistically significant(P<0.05);According to the standard of cardiac injury,2D-STI measured parameters GLS and GCS as predictors of cardiotoxicity,GLS(AUC 0.95;cutoff-16.15%;sensitivity 92%;specificity 86%;P<0.05)and GCS in AC group(AUC 0.85;cutoff value-18.70%;sensitivity 85%;specificity 71%;P < 0.05);GLS in AC+RT group(AUC 0.96;cutoff value-14.40%;sensitivity 91%;specificity 89 %;P < 0.05)and GCS(AUC 0.90;cutoff value-15.25%;sensitivity 82%;specificity 78%;P < 0.05);RT group GLS(AUC 0.98;cutoff value-15.45%;sensitivity 98 %;specificity 75%;P< 0.05)and GCS(AUC 0.87;cutoff value 15.85%;sensitivity 83%;specificity 75%;P < 0.05),both had good diagnostic performance(P < 0.05).Conclusion:Conventional echocardiography and 2D-STI measurement parameters have a good value in evaluating the cardiac injury related to breast cancer treatment,and the changes of left ventricular systolic function parameters in patients with different treatment plans are different.Group patients should focus on monitoring,2D-STI is more sensitive in monitoring cardiac damage,2D-STI measurement parameters GLS and GCS are good predictors of the development of cardiotoxicity induced by breast cancer treatment,and have good diagnostic performance.