scholarly journals Global Longitudinal Strain as a Predictor of Chemotherapy-Induced Cardiotoxicity

2021 ◽  
Author(s):  
Monica Samuel Avila ◽  
Marco Stephan Lofrano Alves ◽  
Silvia Moreira Ayub-Ferreira ◽  
Mauro Rogerio de Barros Wanderley Junior ◽  
Fatima das Dores Cruz ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Serum Levels ◽  
Imaging Parameters ◽  
Important Complication ◽  
Patients At Risk ◽  
Post Hoc

Abstract Background Chemotherapy-induced cardiotoxicity (ChC) is an important complication among patients receiving anthracyclines. Biomarkers and imaging parameters have been studied for their ability to identify patients at risk of developing this complication. Left ventricle global longitudinal strain (LV-GLS) has been described as a sensitive parameter for detecting systolic dysfunction, even in the presence of preserved left ventricle ejection fraction (LVEF). Objective to evaluate the role of the LV-GLS as a predictor of ChC. Methods This study is a post-hoc analysis of CECCY trial (Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity) that evaluated the primary prevention of cardiotoxicity with carvedilol during doxorubicin chemotherapy in a population with breast cancer. Cardiotoxicity was defined as a reduction ≥10% in LVEF. LV-GLS was obtained before chemotherapy in patients with no prior cardiovascular disease or echocardiogram abnormalities. Results Thirty-one patients who had a complete echocardiography study including measurement of LV-GLS before chemotherapy were included in this analysis. An absolute LV-GLS <16.9% before chemotherapy showed 100% sensitivity and 73% specificity for predicting cardiotoxicity (AUC=0.85; 95%CI 0.680 – 0.959, p<0.001). In this population, LVEF values before chemotherapy did not predict ChC (95%CI 0.478 to -0.842, p=0.17). The association of low LV-GLS (<17%) and BNP serum levels (>17 pg/mL) two months after chemotherapy increased the accuracy for detecting early onset ChC (100% sensitivity, 88% specificity, AUC=0.94; 95%CI 0.781 – 0.995, p<0.0001). Conclusions Our data suggest that LV-GLS is a potential predictor of chemotherapy-induced cardiotoxicity. Larger studies are needed to confirm the clinical relevance of this echocardiographic parameter in this clinical setting.

scholarly journals The Role of Speckle Strain Echocardiography in the Diagnosis of Early Subclinical Cardiac Injury in Cancer Patients—Is There More Than Just Left Ventricle Global Longitudinal Strain?

2021 ◽  
Vol 10 (1) ◽  
pp. 154
Author(s):  
Michal Laufer-Perl ◽  
Dan Gilon ◽  
Livia Kapusta ◽  
Zaza Iakobishvili
Keyword(s):  
Cancer Therapy ◽  
Left Ventricle ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Cardiac Injury ◽  
Cancer Therapies ◽  
The Common ◽  
Improvement In Survival ◽  
Strain Echocardiography

With the improvement in survival rate, cardiotoxicity has emerged as a significant adverse effect of cancer therapy. Early diagnosis of subclinical cardiac injury may allow the initiation of cardioprotective therapy and preventing the interruption of optimal cancer therapy and the development of irreversible cardiac dysfunction. In this article, we review the role of two-dimensional speckle tracking echocardiography (2D-STE), beyond the common left ventricle global longitudinal strain in the diagnosis of early subclinical cardiac injury in patients treated with cancer therapies.

scholarly journals CORELATION OF GLOBAL LONGITUDINAL STRAIN (GLS) – LEFT VENTRICLE AND SOLUBLE SUPRESSION OF TUMORGENICITY 2 (sST2) IN ACUTE HEART FAILURE WITH SYSTOLIC DYSFUNCTION

2019 ◽  
Vol 39 (4) ◽  
Author(s):  
Herlina Yulidia ◽  
Muhammad Aminuddin ◽  
Budi S Pikir
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Longitudinal Strain ◽  
Significant Positive Correlation ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Soluble St2 ◽  
Positive Correlation

Background  :  Assessment of  left  ventricular  function  in  patients with   acute heart failure is important for prognostication, determination of treatment plan, for decisions related to  expensive device therapies and for assessing response  to treatment. Echocardiography is the "gold standard" of assessing left ventricular function, and in establishing a diagnosis of heart failure. Left ventricular Global Longitudinal Strain (GLS) assessed through Speckle Tracking Echocardiography (STE) is currently considered sensitive in assessing left ventricular motion, by analyzing multidimensional myocardial deformation . s ST2 used to be correlated with stretch miocard and inhibid ligand of IL-33 wich also inhibit the cardioprotectve effect. Objective : To prove the positive correlation between GLS-left ventricle with soluble ST2. Methods  :  This  is  a  correlational  study  with  cosecutive   sampling   technique. Thirty subjects participate in this reseach and each subject underwent echocardiography and  GLS-left  ventricle  and  soluble ST2 blood examination. The correlation between GLS-left ventricle and soluble ST2  were  evaluated using Spearman correlation test. Results : There is a strong, significant, positive correlation between the GLS-left ventricle with soluble ST2 (r = 0.99 and p =  0.0001). Conclusion : There is a  strong,  significant,  positive  correlation  between  the  GLS- left ventricle with soluble ST2. Keywords :  acute  heart  failure,   systolic   dysfunction,   global  longitudinal  strain, soluble ST2.

Supplementary role of left ventricular global longitudinal strain for predicting sudden cardiac death in hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
Hyun-Jung Lee ◽  
Hyung-Kwan Kim ◽  
Sang Chol Lee ◽  
Jihoon Kim ◽  
Jun-Bean Park ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Risk Score ◽  
Primary Endpoint ◽  
Cardiac Death ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
C Statistic

Abstract Aims We investigated the prognostic role of left ventricular global longitudinal strain (LV-GLS) and its incremental value to established risk models for predicting sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). Methods and results LV-GLS was measured with vendor-independent software at a core laboratory in a cohort of 835 patients with HCM (aged 56.3 ± 12.2 years) followed-up for a median of 6.4 years. The primary endpoint was SCD events, including appropriate defibrillator therapy, within 5 years after the initial evaluation. The secondary endpoint was a composite of SCD events, heart failure admission, heart transplantation, and all-cause mortality. Twenty (2.4%) and 85 (10.2%) patients experienced the primary and secondary endpoints, respectively. Lower absolute LV-GLS quartiles, especially those worse than the median (−15.0%), were associated with progressively higher SCD event rates (P = 0.004). LV-GLS was associated with an increased risk for the primary endpoint, independent of the LV ejection fraction, apical aneurysm, and 2014 European Society of Cardiology (ESC) risk score [adjusted hazard ratio (aHR) 1.14, 95% confidence interval (CI) 1.02–1.28] or 2011 American College of Cardiology/American Heart Association (ACC/AHA) risk factors (aHR 1.18, 95% CI 1.05–1.32). LV-GLS was also associated with a higher risk for the composite secondary endpoint (aHR 1.06, 95% CI 1.01–1.12). The addition of LV-GLS enhanced the performance of the ESC risk score (C-statistic 0.756 vs. 0.842, P = 0.007) and the 2011 ACC/AHA risk factor strategy (C-statistic 0.743 vs. 0.814, P = 0.007) for predicting SCD. Conclusion LV-GLS is an important prognosticator in patients with HCM and provides additional information to established risk stratification strategies for predicting SCD.

scholarly journals Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography

2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Myocardial Mechanics

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.

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