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Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review

Journal of the American College of Cardiology, 2014-07, Vol.63 (25 Pt A), p.2751 [Peer Reviewed Journal]

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2014.01.073 ;PMID: 24703918

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Title:
Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review
Author: Thavendiranathan, Paaladinesh ; Poulin, Frédéric ; Lim, Ki-Dong ; Plana, Juan Carlos ; Woo, Anna ; Marwick, Thomas H
Subjects: Antineoplastic Agents - adverse effects ; Antineoplastic Agents - therapeutic use ; Cardiomyopathies - chemically induced ; Cardiomyopathies - diagnostic imaging ; Cardiomyopathies - physiopathology ; Early Diagnosis ; Echocardiography, Doppler - methods ; Echocardiography, Three-Dimensional - methods ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - drug effects ; Heart Ventricles - physiopathology ; Humans ; Neoplasms - drug therapy ; Reproducibility of Results ; Ventricular Function - drug effects
Is Part Of: Journal of the American College of Cardiology, 2014-07, Vol.63 (25 Pt A), p.2751
Description: The literature exploring the utility of advanced echocardiographic techniques (such as deformation imaging) in the diagnosis and prognostication of patients receiving potentially cardiotoxic cancer therapy has involved relatively small trials in the research setting. In this systematic review of the current literature, we describe echocardiographic myocardial deformation parameters in 1,504 patients during or after cancer chemotherapy for 3 clinically-relevant scenarios. The systematic review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the EMBASE (1974 to November 2013) and MEDLINE (1946 to November 2013) databases. All studies of early myocardial changes with chemotherapy demonstrate that alterations of myocardial deformation precede significant change in left ventricular ejection fraction (LVEF). Using tissue Doppler-based strain imaging, peak systolic longitudinal strain rate has most consistently detected early myocardial changes during therapy, whereas with speckle tracking echocardiography (STE), peak systolic global longitudinal strain (GLS) appears to be the best measure. A 10% to 15% early reduction in GLS by STE during therapy appears to be the most useful parameter for the prediction of cardiotoxicity, defined as a drop in LVEF or heart failure. In late survivors of cancer, measures of global radial and circumferential strain are consistently abnormal, even in the context of normal LVEF, but their clinical value in predicting subsequent ventricular dysfunction or heart failure has not been explored. Thus, this systematic review confirms the value of echocardiographic myocardial deformation parameters for the early detection of myocardial changes and prediction of cardiotoxicity in patients receiving cancer therapy.
Publisher: United States
Language: English
Identifier: EISSN: 1558-3597
DOI: 10.1016/j.jacc.2014.01.073
PMID: 24703918
Source: Geneva Foundation Free Medical Journals at publisher websites
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Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2014.01.073 ;PMID: 24703918

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