Abo El Magd Rasheed Reham Selmy, Mohammed Fathy El Sokkary Hatem, El Amrosy Mahmoud Zaki, El Sayd El Setiha Mohammed, Salama Mai Mohammed Abd El Moneim
Cardiology Department, Tanta University Hospital, El Gharbia, Egypt.
J Saudi Heart Assoc. 2022 Jul 1;34(1):32-40. doi: 10.37616/2212-5043.1296. eCollection 2022.
To investigate the role of myocardial strain imaging by echocardiography is for detecting anthracycline-induced cardiotoxicity early.
Fifty patients had transthoracic echocardiogram before, during, and after taking anthracyclines. GE Vivid E9 Ultrasound System was used for echocardiographic examination and myocardial strain imaging. All patients were assessed three times: on the first visit, before starting anthracycline medication; on the second visit, three months later; and on the third visit, six months later.
Cardiotoxicity occurred in 4 patients at the end of the research. There was a statistically significant association between percentage change in global longitudinal strain (GLS) and ejection fraction (EF) at 3 months p < 0.001 and 6 months p < 0.001. Change in the GLS at 3 months and 6 months had a sensitivity and specificity of 100%, 95.65%, and 100%, 89.13% respectively. Using receiver operating characteristic curve (ROC) for change in GLS showed that Area Under a Curve (AUC) = 1.000, sensitivity, specificity, positive predictive value, and negative predictive value all equals 100%.
Strain echocardiographic examination using GLS is a good predictor for early detection of left ventricle dysfunction caused by anthracyclines chemotherapy.
探讨超声心动图心肌应变成像在早期检测蒽环类药物所致心脏毒性中的作用。
50例患者在服用蒽环类药物前、服药期间及服药后均接受经胸超声心动图检查。采用GE Vivid E9超声系统进行超声心动图检查及心肌应变成像。所有患者均接受三次评估：第一次就诊，在开始服用蒽环类药物前；第二次就诊，三个月后；第三次就诊，六个月后。
研究结束时4例患者出现心脏毒性。3个月时整体纵向应变（GLS）百分比变化与射血分数（EF）之间存在统计学显著关联（p<0.001），6个月时也存在统计学显著关联（p<0.001）。3个月和6个月时GLS的变化分别具有100%、95.65%以及100%、89.13%的敏感性和特异性。使用GLS变化的受试者工作特征曲线（ROC）显示曲线下面积（AUC）=1.000，敏感性、特异性、阳性预测值和阴性预测值均等于100%。
使用GLS的应变超声心动图检查是早期检测蒽环类药物化疗所致左心室功能障碍的良好预测指标。
