Global longitudinal strain: an early marker for cardiotoxicity in patients treated for breast cancer

• DOI: 10.1007/s12471-022-01734-3
• Publication Date: 2022-11-26T18:38:01Z
• Authors: D. van der Linde; I. van Hagen; K. Veen; H. Zuetenhorst; B. van Dalen
• Keywords: Clinical endpoint; Subclinical infection; Cardiotoxicity

Patients treated with anthracyclines and trastuzumab are at increased risk of developing heart failure. Early diagnosis treatment may prevent irreversible left ventricular (LV) dysfunction. This study investigates whether subclinical deterioration global longitudinal strain (GLS) is a more reliable early predictor for LV dysfunction than three-dimensional (3D) ejection fraction (LVEF).Adult patients receiving breast cancer who had serial echocardiographic follow-up were included in this retrospective study. The primary endpoint was the necessity to temporarily pause chemo- or immunotherapy due declining LVEF (decline 3D > 10 percentage points < 53%). Linear mixed-effects models used assess evolution GLS over time.Fifty-one women included, mean age 54 (50.5-57.6) years, total 216 echocardiograms (mean 1.1 ± 0.45 years). significantly correlated (Spearman's rho: -0.36, p 0.001). A decrease predicted lower on subsequent echocardiogram [ß -0.6, 95% confidence interval (CI) (-1.0 -0.2), 0.006]. Conversely, prior did not predict -0.04, CI -0.1 -0.01, = 0.12]. Nine reached endpoint. On average, relative 15% day 205 an absolute 10% 53% 235.GLS able identify earlier measurement undergoing followed by trastuzumab.