Relationship between regional left ventricular dysfunction and cancer-therapy-related cardiac dysfunction.
OBJECTIVE
The aim of our study was to assess the association between risk of cancer-therapy-related cardiac dysfunction (CTRCD) after first follow-up and the difference in echocardiographic measures from baseline to follow-up.


METHODS
We retrospectively enrolled 87 consecutive patients (58±14 years, 55 women) who received anthracycline and underwent echocardiographic examinations both before (baseline) and after initial anthracycline administration (first follow-up). We measured absolute values of global longitudinal strain (GLS), apical longitudinal strain (LS), mid-LS and basal-LS at baseline and first follow-up, and per cent changes (Δ) of these parameters were calculated. Among 61 patients who underwent further echocardiographic examinations (second follow-up, third follow-up, etc), we assessed the association between regional left ventricular (LV) systolic dysfunction from baseline to follow-up and development of CTRCD, defined as LV ejection fraction (LVEF) under 53% and more absolute decrease of 10% from baseline, after first follow-up.


RESULTS
LVEF (65%±4% vs 63±4%, p=0.004), GLS (23.2%±2.6% vs 22.2±2.4%, p=0.005) and basal-LS (21.9%±2.5% vs 19.9±2.4%, p<0.001) at first follow-up significantly decreased compared with baseline. Among the 61 patients who had further follow-up echocardiographic examinations, 13% developed CTRCD. In the Cox-hazard model, worse Δbasal-LS was significantly associated with CTRCD. By Kaplan-Meier analysis, patients with Δbasal-LS decrease of more than the median value (-9.7%) had significantly worse event-free survival than those with a smaller decrease (p=0.015).


CONCLUSIONS
Basal-LS significantly decreased prior to development of CTRCD, and worse basal-LS was associated with development of CTRCD in patients receiving anthracycline chemotherapy.
['Saijo|Yoshihito|Y|', 'Kusunose|Kenya|K|0000-0002-4909-754X', 'Okushi|Yuichiro|Y|', 'Yamada|Hirotsugu|H|0000-0003-3741-5560', 'Toba|Hiroaki|H|', 'Sata|Masataka|M|']
D000903:Antibiotics, Antineoplastic D066126:Cardiotoxicity D004452:Echocardiography D005260:Female D005500:Follow-Up Studies D006331:Heart Diseases D006801:Humans D008297:Male D008875:Middle Aged D009369:Neoplasms D012189:Retrospective Studies D012307:Risk Factors D013318:Stroke Volume D018487:Ventricular Dysfunction, Left D016277:Ventricular Function, Left
echocardiography