Comparative capabilities of the speckle-tracking echocardiography technologiesin two-dimensional and three-dimensional modes in the detection of subclinical cardiotoxicity in patients with breast cancer

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Abstract

Aim. The study was to assess the deformation properties of the left ventricle (LV) myocardium in patients with breast cancer initially and after anthracycline chemotherapy according to 2D and 3D speckle-tracking echocardiography (STE).

Material and methods. the study included 99 patients with triple negative breast cancer with hypertensionandnormotension. All patients underwent standard transthoracic echocardiography with assessment of systolic function of the LV. To assess the indicator of global longitudinal strain (GLS), as a marker of cardiotoxicity, STE was used in two-and three-dimensional modes. In the three-dimensional STE mode, a new strain parameter, the global area strain (GAS) was evaluated.

Results. The study showed that in patients with breast cancer for a more accurate assessment of LV systolic function (ejection fraction) it is advisable to use 3D-echocardiography. A comparative analysis revealed statistically significantly lower values of the GLS according to the three-dimensional mode of STE compared to two-dimensional. The study also evaluated a new strain parameter – GAS (%). In patients with breast cancer during ROC analysis with a value of ³≥-14.0, the GAS indicator for the development of subclinical cardiotoxicity showed a sensitivity of 81.5% and a specificity of 73.3%.

Сonclusion. the advantage of the STE in the three-dimensional mode, in contrast to the two-dimensional mode, is the simultaneous and more accurate assessment of LVEF. The value of the additional parameter of LV deformation – the area of deformation requires further study.

About the authors

M. A. Saidova

National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-3233-1862

д.м.н., проф., рук. отд.

Russian Federation, Moscow

A. A. Avalyan

National Medical Research Center of Cardiology

Author for correspondence.
Email: ani_avalian@mail.ru
ORCID iD: 0000-0003-0442-4495

мл. науч. сотр.

Russian Federation, Moscow

E. V. Oshchepkova

National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-3253-0669

д.м.н., проф., гл. науч. сотр.

Russian Federation, Moscow

V. N. Shitov

National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-8878-7340

мл. науч. сотр. отд.

Russian Federation, Moscow

I. E. Chazova

National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-9822-4357

акад. РАН, д.м.н., проф., зам. ген. дир.

Russian Federation, Moscow

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Supplementary files

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2. Figure: 1. Diagnostic significance of LVEF according to 2D-echocardiography as a marker of cardiotoxicity in breast cancer patients.

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3. Figure: 2. Diagnostic significance of LVEF according to 3D-echocardiography as a marker of cardiotoxicity in breast cancer patients

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4. Figure: 3. GLS indices in BC patients with AH and normotension before and after chemotherapy. Here and below in table. 3: * p <0.05.

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5. Figure: 4. Application of the STE method in a two-dimensional mode in a BC patient with AH before and after CT. Bull's eye presentation.

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6. Figure: 5. Diagnostic significance of GLS index as a marker of cardiotoxicity in breast cancer patients.

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7. Figure: 6. Comparison of STE in terms of GLS in BC patients with AH at baseline and after CT.

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8. Figure: 7. Comparison of STE in terms of GLS in breast cancer patients with normotension at baseline and after chemotherapy.

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9. Figure: 8. Diagnostic significance of GAS as a marker of cardiotoxicity in breast cancer patients with sensitivity 81.5%, specificity 73.3%.

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