Comparative Analysis of Speckle-tracking Echocardiography and Cardio-specific Markers for Early Detection of Cardiotoxicity in Patients With Breast Cancer.

Abstract

Objectives: Breast cancer (BC) treatment often involves cardiotoxic chemotherapy, leading to potential cardiac dysfunction. Early detection of cardiotoxicity is crucial for timely intervention and improved patient outcomes. This study aims to compare the effectiveness of speckle-tracking echocardiography (STE) and cardiospecific markers in detecting early signs of cardiotoxicity in BC patients undergoing chemotherapy.

Methods: The study included 45 women (mean age, 55.8 ± 12 years) diagnosed with HER-2 positive BC. They were treated with doxorubicin and cyclophosphamide for the first four cycles (group-1), docetaxel and Trastuzumab for the second four cycles (group-2), and Trastuzumab for the third four cycles or more subsequent treatment (group-3). Using STE, we assessed the global longitudinal strain of the left ventricle (GLS LV), together with measuring the levels of troponin I and N-terminal pro b-type natriuretic peptide (NT-proBNP) before and after the chemotherapy courses.

Results: Both STE and NT-proBNP were effective in detecting early signs of cardiotoxicity (p < 001). However, STE showed higher sensitivity in detecting subtle changes in cardiac function compared to cardiospecific markers. STE provided valuable information on myocardial deformation, particularly Global Longitudinal Strain (GLS), enabling early intervention by quantifying myocardial deformation along the longitudinal axis.

Conclusions: STE shows promise for early cardiotoxicity detection in BC patients undergoing chemotherapy due to its sensitivity and ability to assess myocardial mechanics. Integrating STE into cardiac monitoring can improve early detection and management. Increases in NT-proBNP correlate with GLS LV changes after CTx, serving as a useful biomarker where STE isn't feasible. Further research is needed to validate findings and standardize protocols.