Aims
To investigate whether alterations of myocardial strain and high‐sensitive cardiac troponin T (cTnT) could predict future cardiac dysfunction in patients after epirubicin exposure.
Methods
Seventy‐five patients with non‐Hodgkin lymphoma treated with epirubicin were studied. Blood collection and echocardiography were performed at baseline, 1 day after the third cycle, and 1 day after completion of chemotherapy. Patients were studied using echocardiography during follow‐up. Global longitudinal (GLS), circumferential (GCS), and radial strain (GRS) were calculated using speckle tracking echocardiography. Left ventricular ejection fraction was analysed by real‐time 3D echocardiography. Cardiotoxicity was defined as a reduction of the LVEF of ≥5% to <55% with symptoms of heart failure or an asymptomatic reduction of the LVEF of ≥10% to <55%.
Results
Fourteen patients (18.67%) developed cardiotoxicity after treatment. GLS (−18.48 ± 1.72% vs. −15.96 ± 1.6%), GCS (−20.93 ± 2.86% vs. −19.20 ± 3.21%), and GRS (39.23 ± 6.44% vs. 34.98 ± 6.2%) were markedly reduced and cTnT was elevated from 0.0010 ± 0.0020 to 0.0073 ± 0.0038 ng/mL (P all < 0.01) at the completion of chemotherapy compared with baseline values. A >15.9% decrease in GLS [sensitivity, 86%; specificity, 75%; area under the curve (AUC) = 0.815; P = 0.001] and a >0.004 ng/mL elevation in cTnT (sensitivity, 79%; specificity, 64%; AUC = 0.757; P = 0.005) from baseline to the third cycle of chemotherapy predicted later cardiotoxicity. The decrease in GLS remained the only independent predictor of cardiotoxicity (P = 0.000).
Conclusions
GLS combined with cTnT may provide a reliable and non‐invasive method to predict cardiac dysfunction in patients receiving anthracycline‐based chemotherapy.
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