Speckle tracking analysis for early detection of cardiotoxicity in breast cancer patients

Abstract

The aim of this retrospective study was to detect early cardiotoxicity by speckle tracking analysis. We analyzed 2D and 3D echocardiographic datasets (2DE and 3DE) in 65 patients treated for breast cancer with anthracycline and trastuzumab. We compared the temporal variations of the left ventricular ejection fraction (LVEF) obtained analyzing 2D and 3D datasets and of the strain values computed before, during and after chemotherapy administration. In addition, in a subgroup of 45 patients a complete echocardiographic examination was performed 6 months after completion of therapy. Cardiotoxicity onset definition varies depending on the method used to compute LVEF (16.9% by 2DE and 50.8% by 3DE). Thirty-three patients developed cardiotoxicity. Nine of them showed a reduction of longitudinal and radial strain values before LVEF reduction at the 16th week. Through 3D speckle tracking analysis early diagnosis of the cardio-toxicity onset seems achievable allowing the planning of cardio protective therapy without interrupting chemotherapy administration.