Sartorio Andrea, Cristin Luca, Pont Chiara Dal, Farzaneh-Far Afshin, Romano Simone
Department of Internal Medicine, Section of Internal Medicine C, University of Verona, Italy.
Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA.
Prog Cardiovasc Dis. 2025 Mar-Apr;89:92-101. doi: 10.1016/j.pcad.2025.01.001. Epub 2025 Jan 9.
Ejection fraction (EF) is the principal parameter used clinically to assess cardiac function and provides prognostic information. However, significant myocardial damage can be present despite preserved EF. Recently, the measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel early marker of cardiac dysfunction. Cardiotoxicity is a frequent side effect of several drugs most notably those used in the treatment of cancer. Although oncology drugs remain the best known cardiotoxic medications, many other drugs can potentially affect LV function. The early recognition of LV dysfunction due to cardiotoxicity is important and of increasing clinical relevance particularly with the rapid pace of development of new drugs. The aim of our review is to provide an overview of the current literature regarding utility of GLS to assess drug-induced myocardial damage. We propose that GLS is a sensitive early marker of myocardial dysfunction associated with the use of certain medications with high risk of cardiotoxicity. Thus, the use of this technique can potentially alert the clinician to myocardial toxicity before reductions in EF are seen.
射血分数（EF）是临床上用于评估心脏功能的主要参数，并提供预后信息。然而，尽管EF保留，但仍可能存在显著的心肌损伤。最近，通过整体纵向应变（GLS）测量左心室（LV）变形已被引入作为心脏功能障碍的一种新型早期标志物。心脏毒性是几种药物常见的副作用，最显著的是用于治疗癌症的药物。尽管肿瘤药物仍然是最广为人知的具有心脏毒性的药物，但许多其他药物也可能影响左心室功能。早期识别由心脏毒性引起的左心室功能障碍很重要，并且在临床上的相关性日益增加，特别是在新药快速发展的情况下。我们综述的目的是概述当前关于GLS用于评估药物性心肌损伤效用的文献。我们提出GLS是与使用某些具有高心脏毒性风险的药物相关的心肌功能障碍的敏感早期标志物。因此，使用该技术有可能在EF降低之前提醒临床医生注意心肌毒性。
