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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

Citation

Thavendiranathan, P and Poulin, F and Lim, KD and Plana, JC and Woo, A and Marwick, TH, 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, 63, (25) pp. 2751-2768. ISSN 0735-1097 (2014) [Refereed Article]

Copyright Statement

Copyright 2014 Elsevier

DOI: doi:10.1016/j.jacc.2014.01.073

Abstract

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 1504 patients during or after cancer chemotherapy for three clinically relevant scenarios. The systematic review was performed following the PRISMA guidelines using 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 LVEF. Using tissue Doppler-based strain imaging, peak systolic longitudinal strain rate has most consistently detected early myocardial changes during therapy, while with speckle tracking echocardiography (STE), peak systolic global longitudinal strain (GLS) appears to be the best measure. A 10-15% 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 left ventricular ejection fraction (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.

Item Details

Item Type:Refereed Article
Keywords:chemotherapy, cardiotoxicity, tissue Doppler, speckle tracking echocardiography
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
ID Code:92621
Year Published:2014
Web of Science® Times Cited:248
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-06-24
Last Modified:2017-10-31
Downloads:0

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