ROLE OF TWO-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY FOR EVALUATION OF LEFT VENTRICULAR DYSFUNCTION IN ANTHRACYCLINE -INDUCED CARDIOTOXICITY IN BREAST CANCER PATIENTS.

Background: Cardiotoxicity is an important complication of several cancertherapeutic agents such as anthracyclines. Improved cancer survival togetherwith better awareness of the late effects of cardiotoxicity has led togrowing recognition of the need for surveillance of anthracycline-treated cancer survivors with early intervention to treat or preventheart failure. Strain-based imaging techniques and specifically speckle-tracking echocardiography (STE) have been shown to have clinical utility in a variety of settings. Aim of work: This study aimed to assess the value of 2D speckle-tracking echocardiography for the early detection of left ventricular dysfunction in breast cancer patients on chemotherapeutic treatment with anthracyclines. Patients and Methods: The study recruited 70 women with newly diagnosed cancer breast. Before start of treatment, they were subjected to careful cardiac and echocardiographic assessment including STE evaluation in addition to the other clinical and laboratory investigations indicated in such situations. After completion of treatment, women had undergone similar cardiological and echocardiographic evaluation. Results:In the present study, comparison between pretreatment andpost treatment echocardiographic data revealed significant changes inboth systolic and diastolic functions of the left ventricle. Importantly, the present study found that conventional echocardiographic assessment could identify 12 patients (17.1 %) defined according toreduced LVEF while STE recognized cardiotoxicity in 22 patients(31.4 %) according to reduced GLS. In respect to diastolic dysfunction, the present study reported that 34 patients (48.6 %) had diastolic dysfunction after anthracyclines treatment. Comparative analysis between patients with diastolic dysfunction and patients without in the current study showed that patients with diastolic dysfunction had significantly higher impairment of ejection fraction and GLS. Conclusions: Speckle-tracking Echocardiography provides a useful tool in the detection of anthracyclines -induced cardiotoxicity