Speckle-tracking echocardiography in 3D mode in assessing the deformation of the myocardium and identifying subclinical cardiotoxicity during chemotherapy in breast cancer patients with arterial hypertension

Abstract

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.