Moreno-Martínez FL, Hernández SS, del Pino HCV, Gómez GJA, Rodríguez CCE

Language: Spanish
References: 23
Page: 44-50
PDF size: 876.79 Kb.

ABSTRACT

Introduction: Assessment of myocardial function is critical for decision making during the follow-up of patients with oncologic diseases undergoing chemotherapy. Two-dimensional speckle-tracking techniques help to determine the degree of myocardial fiber deformation and provide a more direct measure of systolic function than left ventricular ejection fraction (LVEF).
Objective: To evaluate myocardial function by means of echocardiography in patients with oncological diseases undergoing chemotherapy.
Methods: A prospective longitudinal descriptive study was performed in 21 patients diagnosed with cancer and with indication for chemotherapy with trastuzumab, in the Hospital of Fuerteventura (Spain), between January 2017 and May 2020. All underwent transthoracic echocardiography with speckle-tracking technique (global longitudinal strain) before treatment and during follow-up.
Results: Women (95.2%) with a diagnosis of breast cancer (90.5%) predominated and the mean age was 53.8 years (range 38-75). Left ventricular ejection fraction and global longitudinal strain were normal (100%) before starting chemotherapy. It was necessary to suspend treatment in 3 patients (14.3%); but only in 2 of them (9.5%) due to cardiotoxicity detected by echocardiography. Five patients (23.8%) presented symptoms of heart failure, 1 (4.8%) had cardiotoxicity and in the other 4 (19.0%) the absence of myocardial dysfunction was demonstrated, so that treatment could be continued safely.
Conclusions: Two-dimensional speckle-tracking echocardiography was of vital importance for assessing myocardial performance and guiding chemotherapy in patients with oncologic diseases.

REFERENCES

1. Hulvat MC. Cancer Incidence and Trends. Surg Clin North Am. 2020;100(3):469-81. DOI: https://doi.org/10.1016/j.suc.2020.01.002

2. Nakanishi K, Daimon M. Early prediction of cardiotoxicity from cancer chemotherapy - Can Baseline strain identify high-risk patients? Circ J. 2018;82(10):2477-8. DOI: https://doi.org/10.1253/circj.cj-18-0836

3. Mattiuzzi C, Lippi G. Current Cancer Epidemiology. J Epidemiol Glob Health. 2019;9(4):217-22. DOI: https://doi.org/10.2991/jegh.k.191008.001

4. Gripp EA, Oliveira GE, Feijó LA, Garcia MI, Xavier SS, Sousa AS. Global longitudinal strain accuracy for cardiotoxicity prediction in a cohort of breast cancer patients during anthracycline and/or trastuzumab treatment. Arq Bras Cardiol. 2018;110(2):140-50. DOI: https://doi.org/10.5935/abc.20180021

5. Oikonomou EK, Kokkinidis DG, Kampaktsis PN, Amir EA, Marwick TH, Gupta D, et al. Assessment of prognostic value of left ventricular global longitudinal strain for early prediction of chemotherapy-induced cardiotoxicity: A systematic review and meta-analysis. JAMA Cardiol. 2019;4(10):1007-18. DOI: https://doi.org/10.1001/jamacardio.2019.2952

6. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16(1):1-11. DOI: https://doi.org/10.1093/ehjci/jeu184

7. López-Fernández T, Martín García A, Santaballa Beltrán A, Montero Luis A, García Sanz R, Mazón Ramos P. Cardio-Onco-Hematología en la práctica clínica. Documento de consenso y recomendaciones. Rev Esp Cardiol. 2017;70(6):474-86. DOI: https://doi.org/10.1016/j.recesp.2016.12.021

8. López-Fernández T, Thavendiranathan P. Nuevas técnicas de imagen cardiaca en la detección precoz de cardiotoxicidad secundaria a tratamientos oncológicos. Rev Esp Cardiol. 2017;70(6):487-95. DOI: https://doi.org/10.1016/j.recesp.2016.12.027

9. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32(1):1-64. DOI: https://doi.org/10.1016/j.echo.2018.06.004

10. Galderisi M, Cosyns B, Edvardsen T, Cardim N, Delgado V, Di Salvo G, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2017;18(12):1301-10. DOI: https://doi.org/10.1093/ehjci/jex244

11. Plana JC, Galderisi M, Barac A, Ewer MS, Ky B, Scherrer-Crosbie M, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: A report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2014;27(9):911-39. DOI: https://doi.org/10.1016/j.echo.2014.07.012

12. Toufan M, Pourafkari L, Ghahremani Nasab L, Esfahani A, Sanaat Z, Nikanfar A, et al. Two-dimensional strain echocardiography for detection of cardiotoxicity in breast cancer patients undergoing chemotherapy. J Cardiovasc Thorac Res. 2017;9(1):29-34. DOI: https://doi.org/10.15171/jcvtr.2017.04

13. Arciniegas Calle MC, Sandhu NP, Xia H, Cha SS, Pellikka PA, Ye Z, et al. Two-dimensional speckle tracking echocardiography predicts early subclinical cardiotoxicity associated with anthracycline-trastuzumab chemotherapy in patients with breast cancer. BMC Cancer [Internet]. 2018 [citado 30/09/2020];18(1):1037. Disponible en: https://doi.org/10.1186/s12885-018-4935-z

14. Gómez A, Rebollo E, Américo C, Janssen B, Pazos A, Castillo C, et al. Cardiotoxicidad por trastuzumab en pacientes con cáncer de mama. Serie de casos. Rev Urug Cardiol. 2019;34(1):85-107.

15. Morales Yera RA, Sierra Pérez L, Triana Díaz A. Cardiotoxicidad inducida por quimioterapia. CorSalud [Internet]. 2018 [citado 27/09/2020];10(1):68-77. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/295/632

16. Almeida AG. Subclinical cardiotoxicity in cancer therapy: The impact of early detection. Rev Port Cardiol. 2017;36(1):17-9. DOI: https://doi.org/10.1016/j.repc.2016.10.003

17. Portugal G, Moura Branco L, Galrinho A, Mota Carmo M, Timóteo AT, Feliciano J, et al. Global and regional patterns of longitudinal strain in screening for chemotherapy-induced cardiotoxicity. Rev Port Cardiol. 2017;36(1):9-15. DOI: https://doi.org/10.1016/j.repc.2016.06.009

18. Fei HW, Ali MT, Tan TC, Cheng KH, Salama L, Hua L, et al. Left ventricular global longitudinal strain in HER-2 + breast cancer patients treated with anthracyclines and trastuzumab who develop cardiotoxicity is associated with subsequent recovery of left ventricular ejection fraction. Echocardiography. 2016;33(4):519-26. DOI: https://doi.org/10.1111/echo.13168

19. Ye L, Yang ZG, Selvanayagam JB, Luo H, Yang TZ, Perry R, et al. Myocardial strain imaging by echocardiography for the prediction of cardiotoxicity in chemotherapy-treated patients: A meta-analysis. JACC Cardiovasc Imaging. 2020;13(3):881-2. DOI: https://doi.org/10.1016/j.jcmg.2019.09.013

20. Alam S, Chandra S, Saran M, Chaudhary G, Sharma A, Bhandhari M, et al. To study the usefulness and comparison of myocardial strain imaging by 2D and 3D echocardiography for early detection of cardiotoxicity in patients undergoing cardiotoxic chemotherapy. Indian Heart J. 2019;71(6):468-75. DOI: https://doi.org/10.1016/j.ihj.2019.11.253

21. Charbonnel C, Convers-Domart R, Rigaudeau S, Taksin AL, Baron N, Lambert J, et al. Assessment of global longitudinal strain at low-dose anthracycline-based chemotherapy, for the prediction of subsequent cardiotoxicity. Eur Heart J Cardiovasc Imaging. 2017;18(4):392-401. DOI: https://doi.org/10.1093/ehjci/jew223

22. Santoro C, Arpino G, Esposito R, Lembo M, Paciolla I, Cardalesi C, et al. 2D and 3D strain for detection of subclinical anthracycline cardiotoxicity in breast cancer patients: a balance with feasibility. Eur Heart J Cardiovasc Imaging. 2017;18(8):930-6. DOI: https://doi.org/10.1093/ehjci/jex033

23. Thavendiranathan P, Negishi T, Coté MA, Penicka M, Massey R, Cho GY, et al. Single versus standard multiview assessment of global longitudinal strain for the diagnosis of cardiotoxicity during cancer therapy. JACC Cardiovasc Imaging. 2018;11(8):1109-18. DOI: https://doi.org/10.1016/j.jcmg.2018.03.003