Role of Myocardial Strain Imaging by Echocardiography for the Early Detection of Anthracyclines-Induced Cardiotoxicity

OBJECTIVE: To investigate the role of myocardial strain imaging by echocardiography is for detecting anthracycline-induced cardiotoxicity early. PATIENTS AND METHODS: Fifty patients had transthoracic echocardiogram before, during, and after taking anthracyclines. GE Vivid E9 Ultrasound System was used for echocardiographic examination and myocardial strain imaging. All patients were assessed three times: on the first visit, before starting anthracycline medication; on the second visit, three months later; and on the third visit, six months later. RESULTS: Cardiotoxicity occurred in 4 patients at the end of the research. There was a statistically significant association between percentage change in global longitudinal strain (GLS) and ejection fraction (EF) at 3 months p < 0.001 and 6 months p < 0.001. Change in the GLS at 3 months and 6 months had a sensitivity and specificity of 100%, 95.65%, and 100%, 89.13% respectively. Using receiver operating characteristic curve (ROC) for change in GLS showed that Area Under a Curve (AUC) = 1.000, sensitivity, specificity, positive predictive value, and negative predictive value all equals 100%. CONCLUSION: Strain echocardiographic examination using GLS is a good predictor for early detection of left ventricle dysfunction caused by anthracyclines chemotherapy.