Comparison of the conventional echocardiographic parameters with the global longitudinal strain of the left and right ventricle, in the low-dose anthracycline treatment in patients with the low CV risk.

Abstract Introduction: /Purpose Breast cancer patients undergoing chemotherapy are at risk of chemotherapy-induced cardiovascular toxicity (CTR-CVT). The right ventricle (RV) may also be susceptible to CTR-CVT and may exhibit symptoms of dysfunction before the left ventricle. Our study aims to compare the effectiveness of conventional echocardiographic parameters with the global longitudinal strain techniques in patients receiving low-dose anthracycline treatment and having low cardiovascular risk. Methods: In a recent study, 28 women with low cardiovascular risk who underwent low-dose anthracycline chemotherapy for breast cancer were assessed for cardiac function using 2D echocardiography and speckle-tracking echocardiography. The measurements included LVEF, RVS’, TAPSE, LVGLS, and RVGLS. All patients had normal LVEF at the beginning of the study. Cardiotoxicity was defined as a new decrease in LVEF by 10% or below 53%, and/or changes in LVGLS/RVGLS by 15%. Results: Our study found that the LVGLS decreased from -21.2%±2.1% to -18.6%±2.6% (t-test = -4.116; df = 54, p=0.001). Similarly, the RVGLS decreased from -25.2%±2.9% to -21.4%±4.4% (t-test = -3.82; df = 54, p=0.001). However, the measurements of right ventricular systolic function (RVS), tricuspid annular plane systolic excursion (TAPSE), and the left ventricular ejection fraction (LVEF) were insignificant. Conclusion: (s) The study’s findings suggest that relatively new imaging technique GLS measurements are more sensitive than conventional echocardiographic parameters ( LVEF, TAPSE, RVS) for the detection of myocardial damage and a potential decline in cardiac function at the early stages of chemotherapy treatment. Moreover, RV-GLS is more sensitive to these changes despite the dosage and regimen of the chemotherapy.