Objective. To study the possibility of the 2D Speckle Tracking Imaging in early detection of cardiotoxicity in patients with triple negative breast cancer and arterial hypertension (AH) during anthracycline-containing chemotherapy. Materials and methods. 70 women (mean age 48.6±13.3 years) with triple negative breast cancer were enrolled. All patients underwent chemotherapy, including anthracycline, taxan, platinum-based agent. Echocardiography, including 2D Speckle Tracking Imaging, was performed on Vivid-E 9 ultrasound machine before and after 8 weeks of chemotherapy. Left ventricular ejection fraction (LVEF) (the biplane Simpson`s method) and global longitudinal strain (GLS) (mean normal GLS of -22.1±1.8 for women) were analysed. Patients were divided into two groups: group 1 - with AH (n=18) and group 2 - with normal blood pressure (n=52). Results. Before chemotherapy in group 1 GLS was lower than normal value (-19.1±2.8% vs -22.1±1.8%; p0.05). After chemotherapy in all patients GLS decrease was observed from -20.0±2.8% to -18.5±2.9% (p
Objective. To study of subclinical cardiotoxicity of two anthracycline-containing chemotherapy regimens in breast cancer patients with normotension and arterial hypertension. Materials and methods. 119 women (mean age 48,8±10,9 years) with triple negative breast cancer were enrolled. They are received one of two chemotherapy options that differed in the intensity and duration of treatment, including the total dose of anthracyclines. Depending on the chemotherapy option, the patients were divided into two groups: group 1 (n=54) - treatment duration ≤8 weeks, cumulative dose of doxorubicin was 200 mg/m2, group 2 (n=65) - treatment duration ≤16 weeks, the cumulative dose of doxorubicin was 320 mg/m2. Before and after chemotherapy completion of all patients, the level of troponin T (h.s.) and NT-proBNP was determined, and heart ultrasound was performed, 2D and 3D speckle tracking imaging. Results. In patients who received a higher cumulative dose of doxorubicin (group 2), a statistically significant increase in biomarkers of myocardial damage was observed (h.s. troponin T before chemotherapy was 7.8±0.5 pg/ml, after chemotherapy - 55.0±7.0 pg/ml, p
Aim.To study the possibilities of speckle-tracking echocardiography (STE) in 3D mode in assessing the strain of the myocardium and identifying subclinical cardiotoxicity during anthracycline-containing chemotherapy in breast cancer patients with arterial hypertension. Materials and methods.The study included 47 patients with triple negative breast cancer (BC) with AH and normotension. All patients underwent transthoracic echocardiography with an assessment of the left ventricular (LV) ejection fraction, also used STE in three-dimensional mode with an assessment of global longitudinal (GLS), circular (GCS), radial (GRS) strain and a new strain parameter strain area (GAS). Results.In patients with BC for a more accurate assessment of LV systolic function, it is advisable to use 3D echocardiography. In BC patients with AH, the initial parameters of LV strain were statistically significantly worse than in patients with normotension and further deterioration was observed after chemotherapy. To determine the sensitivity and specificity of the strain parameters from the 3D-STE data, an ROC analysis was performed. The most diagnostically significant parameter of strain, as a marker of cardiotoxicity, was the global area strain (GAS), which with a cut-off value -14.0% showed a sensitivity equal to 81.5% and a specificity of 73.3%, but the value this parameter of LV deformation requires further study. Conclusion.In BC patients with AH and normotension it is advisable to use the STE in 3D mode to analyze the strain and systolic function of the LV during antitumor treatment. The method is promising for identifying subclinical cardiotoxicity, but further research is needed to develop diagnostic criteria.
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