Anthracycline induced inconsistent left ventricular segmental systolic function variation in patients with lymphoma detected by three-dimensional speckle tracking imaging
- 21 Downloads
Chemotherapy contained anthracycline inevitably cause declines of cardiac function. This study evaluated the deterioration of left ventricular segmental systolic function in patients with lymphoma received anthracycline chemotherapy detected by echocardiographic three dimensional speckle tracking imaging (3D-STI). Sixty patients with newly diagnosed diffuse large B-cell lymphoma who received R-CHOP chemotherapy were enrolled. Three dimensional left ventricular global longitudinal strain (3D-GLS), three dimensional left ventricular global circumferential strain (3D-GCS) and three dimensional left ventricular longitudinal strain of different left ventricular segments (3D-LS) were measured by 3D-STI at baseline, after the completion of two cycles and four cycles of the regimen respectively. Compared with baseline, 3D-GLS reduced significantly after four cycles of anthracycline therapy (P < 0.001), while 3D-GCS showed no significant variation during the whole procedure (all P > 0.05). For individual segment, LS of apical anterior and septal walls decreased significantly after two cycles of chemotherapy (all P < 0.05). After four cycles of treatment, 3D-LS of the mid-ventricular level (all P < 0.05), apical level (all P < 0.05) and apex (P < 0.05) worsened. Serum hs-cTnT levels increased after anthracycline exposure (P < 0.05) and Serum hs-cTnT levels were correlated with 3D-GLS at the end of four cycles (r = 0.12, P = 0.03). Mean values of involved segmental 3D-LS of two and four cycles were both correlated with serum hs-cTnT levels at the end of both two and four cycles (r = 0.368, P = 0.041; r = 0.79, p < 0.001). 3D-STI evaluation of the LV provides an understanding of the segmental impairment of LV wall and the possible process of LV impairment in lymphoma patients after anthracycline chemotherapy.
KeywordsAnthracycline Cardiotoxicity Left ventricular function Strain Echocardiography
This study was supported by grant 2017BR027 from Municipal Human Resources Development Program for Outstanding Leaders in Medical Disciplines in Shanghai, grant 20164Y0076 from Shanghai Health and Family Planning Commission, 81771840 from National Natural Science Foundation of China.
Compliance with Ethical Standards
Conflict of interest
All authors declare no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.National Comprehensive Cancer Network (2015) Clinical practice guidelines in oncology. Breast Cancer, Version1. IOP Publishing PhysicsWeb. https://www.nccn.org/professionals/physician_3D-GLS/f_guidelines.asp,2015
- 2.National Comprehensive Cancer Network (2015) Clinical practice guidelines in oncology. Gastric Cancer, Version1. IOP Publishing PhysicsWeb https://www.nccn.org/professionals/physician_3D-GLS/f_guidelines.asp,2015
- 3.National Comprehensive Cancer Network (2015) Clinical practice guidelines in oncology. Hodgkin’s lymphoma, Version1. IOP Publishing PhysicsWeb https://www.nccn.org/professionals/physician_3D-GLS/f_guidelines.asp,2015
- 5.Okuma H, Noto N, Tanikawa S, Kanezawa K, Hirai M, Shimozawa K, Yagasaki H, Shichino H, Takahashi S (2017) Impact of persistent left ventricular regional wall motion abnormalities in childhood cancer survivors after anthracycline therapy: assessment of global left ventricular myocardial performance by 3D speckle-tracking echocardiography. J Cardiol 70:396–401CrossRefGoogle Scholar
- 7.Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the american society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the european association of echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463CrossRefGoogle Scholar
- 8.Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Int J Cardiovasc Imaging 18:539–542PubMedGoogle Scholar
- 10.Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip G, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM (2016) 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC committee for practice guidelines: the task force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J 37:2768–2801CrossRefGoogle Scholar
- 12.Cardinale D, Colombo A, Torrisi R, Sandri MT, Civelli M, Salvatici M, Lamantia G, Colombo N, Cortinovis S, Dessanai MA, Nolè F, Veglia F, Cipolla CM (2010) Trastuzumab-induced cardiotoxicity: clinical and prognostic implications of troponin I evaluation. J Clin Oncol 28:3910–3916CrossRefGoogle Scholar
- 14.Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, Faletra FF, Franke A, Hung J, de Isla LP, Kamp O, Kasprzak JD, Lancellotti P, Marwick TH, McCulloch ML, Monaghan MJ, Nihoyannopoulos P, Pandian NG, Pellikka PA, Pepi M, Roberson DA, Shernan SK, Shirali GS, Sugeng L, Ten Cate FJ, Vannan MA, Zamorano JL, Zoghbi WA (2012) EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr 25:3–46CrossRefGoogle Scholar
- 15.Cameli M, Mondillo S, Galderisi M, Mandoli GE, Ballo P, Nistri S, Capo V, D’Ascenzi F, D’Andrea A, Esposito R, Gallina S, Montisci R, Novo G, Rossi A, Mele D, Agricola E (2017) Speckle tracking echocardiography: a practical guide. G Ital Cardiol (Rome) 18:253–269Google Scholar
- 17.Santoro C, Arpino G, Esposito R, Lembo M, Paciolla I, Cardalesi C, de Simone G, Trimarco B, De Placido S, Galderisi M (2017) 2D and 3D strain for detection of subclinical anthracycline cardiotoxicity in breast cancer patients: a balance with feasibility. Eur Heart J Cardiovasc Imaging 18:930–936CrossRefGoogle Scholar
- 18.Toro-Salazar OH, Ferranti J, Lorenzoni R, Walling S, Mazur W, Raman SV, Davey BT, Gillan E, O’Loughlin M, Klas B, Hor KN (2016) Feasibility of echocardiographic techniques to detect subclinical cancer therapeutics-related cardiac dysfunction among high-dose patients when compared with cardiac magnetic resonance imaging. J Am Soc Echocardiogr 29:119–131CrossRefGoogle Scholar
- 19.Curigliano G, Cardinale D, Suter T, Plataniotis G, de Azambuja E, Sandri MT, Criscitiello C, Goldhirsch A, Cipolla C, Roila F (2012) Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO clinical practice guidelines. Ann Oncol 23(Suppl 7):i155–i166CrossRefGoogle Scholar
- 20.Song FY, Shi J, Guo Y, Zhang CJ, Xu YC, Zhang QL, Shu XH, Cheng LL (2017) Assessment of biventricular systolic strain derived from the two-dimensional and three-dimensional speckle tracking echocardiography in lymphoma patients after anthracycline therapy. Int J Cardiovasc Imaging 33:857–868CrossRefGoogle Scholar
- 30.Siasos G, Sara JD, Zaromytidou M, Park KH, Coskun AU, Lerman LO, Oikonomou E, Maynard CC, Fotiadis D, Stefanou K, Papafaklis M, Michalis L, Feldman C, Lerman A, Stone PH (2018) Local low shear stress and endothelial dysfunction in patients with nonobstructive coronary atherosclerosis. J Am Coll Cardiol 71:2092–2102CrossRefGoogle Scholar
- 33.Rubini Gimenez M, Badertscher P, Twerenbold R, Boeddinghaus J, Nestelberger T, Wussler D, Miró Ò, Martín-Sánchez FJ, Reichlin T, Mueller C (2018) Impact of the US food and drug administration-approved sex-specific cutoff values for high-sensitivity cardiac troponin t to diagnose myocardial infarction. Circulation 137:1867–1869CrossRefGoogle Scholar