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Objective To assess the toxicity of anthracyclinc to left ventricle function in patients withbreast cancer,and to compare the clinical values between two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Methods 50 patients with breast cancer who had received surgical treatment and epirubicinbased chemotherapy were recruited to study groups.All the patients had undergone up to 6 cycles of chemotherapy.Different stages wcre identified according to accumulated doses of epirubicin reaching 0 mg/m2,120 mg/m2,240 mg/m2 and 360 mg/m2.2D-STE and 3D-STE parameters were measured before chemotherapy and after different stage of chemotherapy.The receiver operating characteristics curves (ROC) of parameters (2D-GLS,3D-GLS,3D-GCS,3DGAS) were graphed to evaluate the specificity and sensitivity of detecting dysfunction of the left ventricles.25 healthy volunteers were recruited to a control group.Results As compared with the control group and the baselines,2D-GLS and 3D-GCS was significantly declined (P ＜ 0.05),3D-GAS and 3D-GLS were significantly lowered after interim period and later period (P ＜ 0.05),while 3D-GRS was not changed significantly during the whole chemotherapy period.The ROC curves revealed the sensitivity of 2D-GLS,3D-GCS,3D-GLS and 3D-GAS for assessing dysfunction of the left ventricles was 60.7％,65.3％,62.7％,and 80.7％,while the specificity was 50.0％,54.0％,64.0％,and 82.0％,respectively.Conclusions As compared with 2D-STE,3D-STE can detect the dysfunction of left ventricles earlier and more accurately.Furthermore,the specificity and sensitivity of 3D-GAS are the highest among all parameters in detecting the early dysfunction of left ventricles.
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Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI)in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving Anthracycline.Methods A group of 63 breast cancer postoperative patients were recruited and received a six-cycle epirubicin-based chemotherapy.Electrocardiogram,conventional echocardiography and 3D-STI parameters were measured before chemotherapy and during 24-48 hours after the cumulative dose of 120 mg/m2 ,240 mg/m2 and 360 mg/m2 .The receiver operating characteristics (ROC ) curves of 3D-STl parameters,such as global area strain(GAS),global longitudinal strain(GLS),global circumferential strain (GCS),and global radial strain(GRS)were drawn to determine optimal sensitivity and specificity.Twenty-one healthy female volunteers served as control subjects.Results Compared with before chemotherapy and control subjects,GAS and GLS were significantly reduced at the cumulative dose of 240 mg/m2 ,360 mg/m2 (P <0.05).The area under ROC of GAS was 0.974,and its optimal cut-off value was -3 1 .5%,with a specificity of 87.1 % and a sensitivity of 92.9%.Moreover,correlation analysis showed GAS was significantly associated with cumulative doxorubicin dose(r = -0.834,P < 0.01 ).Conclusions During chemotherapy,GAS can detect minor LV myocardial dysfunction associated with cardiotoxicity of anthracycline.3D-STI is useful in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving anthracycline.
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Objective To observe heart functions of the patient with cancer receiving combined chemotherapy of paclitaxel plus cisplatin through troponin test and speckle tracking echocardiography. Methods 43 patients who had been scheduled to receive combined chemotherapy of paclitaxel plus cisplatin were recruited in the study. Ser-um cTnT and cTnI levels were measured before chemotherapy,after the first cycle of chemotherapy,middle cycle of chemotherapy and after the last cycle of chemotherapy. In all patients, the lobal longitudinal systolic strain( GSL) and strain rate(GSRs)of the LV as well as peak early-diastolic strain rate (GSRe) and peak late-diastolic strain rate ( GSRa) were measured by two-dimensional speckle tracking echocardiography at every stage. Results The patients' serum cTnT and cTnI level after chemotherapy were increased gradually(P0. 05), but compared to those of the middle and last stage of chemotherapy, significant difference (P<0.01) existed. Conclusion Paclitaxel plus cisplatin induce certain subclinical myocardial injury to patient's heart. Cardiac troponin level and speckle tracking echocardiography have important value in the obser-vation of heart functions of the patients with cancer receiving chemotherapy.