Evaluation Of Cardiotoxicity Of Anthracyclines By Multiparameter Of Echocardiography Combined With Biomarkers

Objective(s):In this study,echocardiography and myocardial damage markers were evaluated before and after chemotherapy with anthracyclines in breast cancer patients,aiming to explore the sensitive markers of myocardial damage caused by chemotherapy drugs and the value of left ventricular myocardial work.Methods:Fifty-five patients diagnosed with breast cancer were collected from the First People’s Hospital of Yunnan Province,and each patient met the inclusion and exclusion criteria.All patients received chemotherapy with anthracyclines for the first time,each chemotherapy cycle included 6 cycles lasting 21 days.Laboratory tests and echocardiographic examinations were performed on the enrolled patients before chemotherapy and during the 2nd,4th and 6th cycle of chemotherpy.Myocardial injury markers,NT-proBNP,conventional echocardiographic indicators,left ventricular long axis strain and myocardial work parameters(Global constructive work index,Global constructive work,Global wasted work,Global work efficiency,)were recorded.Results:1.Markers of myocardial injury and general biochemical data: There were no significant changes in cTnI and NTproBNP before the treatment and after 2nd cycle,4th cycle and 6th cycle of chemotherapy.There were no significant difference in fasting blood glucose,TG,LDL-C,HDL-C and TC after 2nd,4th and 6th cycle compared with before chemotherapy,and there were no statistically significant differences among all groups.2.conventional echocardiogram indicators: There were no significant changes in LVEDd、LVEDs、EDV、ESV、LVEF、LAD、LAVI、LVFS、E、A、E/A and E/e’after 2nd cycle,4th cycle and 6th cycle of chemotherapy,and there was no statistical significance conpared with before chemotherapy.Tei index at T6(0.46±0.03)is higher significantly than Tei index at T0(0.37±0.02)(P<0.05).3.Global longitudinal strain: The GLS of 6th cycles of chemotherapy(-14.54±0.97)was lower than those of 2nd cycle(-17.90±1.23)and before chemotherapy(-18.25±1.19).The differences among all groups were statistically significant(P<0.05).The GLS after 4th cycle of chemotherapy(-14.83±0.96)was lower than before chemotherapy(-18.25±1.19)and after 2nd cycle of chemotherapy(-17.90±1.23).The differences among all groups were statistically significant(P<0.05).4.Myocardial work: The GWI after 6th cycle of chemotherapy(1406.96±108.07)was lower than those of before chemotherapy(1768.58±141.26),2nd cycle(1758.22±134.75)and 4th cycle of chemotherpy(1549.6±147.43).The difference among all groups was statistically significant(P<0.05).The GCW after 6th cycle of chemotherapy(1873.04±89.68)was lower than those of before chemotherapy(1985.76±193.06)and after 2th cycle of chemotherapy(1976.60±199.49).The difference among all groups was statistically significant(P<0.05).The GCW after 4th cycle of chemotherapy(1887.70±218.65)was lower than before chemotherapy(1985.76±193.06)and after 2th cycle of chemotherapy(1976.60±199.49).The difference among all groups was statistically significant(P<0.05).Conclusion(s):GLS,GWI,GCW,and Tei indexes could detect cardiotoxicity of anthracyclines earlier than conventional echocardiographic indicators,troponin,and NT-proBNP.Among these,GLS,GWI,and GCW were able to detect cardiotoxicity of anthracyclines earlier than Tei index.