tbzmedTabriz University of Medical SciencesJCVTRJournal of Cardiovascular and Thoracic ResearchOriginal ArticleJournal of Cardiovascular and Thoracic ResearchTwo-dimensional strain echocardiography for detection of cardiotoxicity in breast cancer patients undergoing chemotherapyStrain echocardiography for anthracycline-induced cardiotoxicityToufanMehrnoush, PourafkariLeili, Ghahremani NasabLeyla, EsfahaniAli, SanaatZohreh, NikanfarAlireza, NaderNaderProfessor at University at Buffalo, Department of Anesthesiology320171832017912892016Tabriz University of Medical Sciences2016Two-dimensional strain echocardiography for detection of cardiotoxicity in breast cancer patients undergoing chemotherapy

<strong><em>Introduction:</em></strong> Two-dimensional (2D) strain echocardiography has emerged as a novel method for early diagnosis of myocardial dysfunction in patients receiving anthracycline chemotherapy. Certain myocardial segments might be more vulnerable for development of dysfunction.<br /> <em><strong>Methods:</strong></em> Sixty-three patients with breast cancer who were deemed amenable for anthracycline chemotherapy were prospectively studied from March 2013 to March 2015 in University Hospital settings. Global left ventricular (LV) ejection fraction (EF), fractional shortening and the strain over 17 segments of the LV were examined using 2-dimensional transthoracic echocardiography (TTE) before and after chemotherapy. More than 15% reduction in longitudinal peak systolic strain (LPSS) was considered significant.<br /> <em><strong>Results:</strong></em> The mean age of patients was 47 &plusmn; 10 years. LVEF was 59.7 &plusmn; 6.5% at baseline. Significant reduction of global LPSS was detected in 13% of patients. A significant LPSS reduction occurred in 32.4% of 1071 segments examined following chemotherapy. LPSS significantly decreased in 28% of apical segments, 31% of mid segments and 37% of basal segments. LPSS reduction occurred more frequently over the basal segments than all other segments (<em>P&thinsp;</em>=&thinsp;0.031). <br /> <em><strong>Conclusion:</strong></em> Segmental pattern appears to exist in LPSS reduction following anthracycline therapy. As significant segmental decreases can be seen in the setting of unchanged global LPSS, segmental evaluation of LPSS might be a more accurate way for assessment of myocardial function.