Three-Dimensional Speckle-Tracking Echocardiography to Evaluate Left Ventricular Function of Patients with Breast Cancer After Anthracycline Chemotherapy.

Objective: To explore the use of 3-dimensional speckle-tracking echocardiography (3DSTE) to evaluate changes in left ventricular function in patients with breast cancer after anthracycline chemotherapy.

Methods: The clinical data of 30 patients with breast cancer diagnosed by pathology at The Third Affiliated Hospital of Qiqihar Medical University from December 2020 to December 2022 were collected for retrospective analysis. All patients received anthracycline chemotherapy, and serum cardiac troponin T (cTnT) concentrations were measured within 24 to 48 hours before chemotherapy and after 1 cycle and 4 cycles of chemotherapy. Then, conventional ultrasonography, routine echocardiography, and 3DSTE were performed to obtain dynamic images and parameters such as left ventricular global longitudinal strain, global area strain, global circumferential strain, global radial strain, and twist values. The myocardial comprehensive index was calculated to compare changes before and after anthracycline chemotherapy. A receiver operating characteristic curve was created for each parameter, and the areas under the curves were calculated.

Results: Except for left ventricular end-diastolic diameter and end-diastolic interventricular septum thickness, the other conventional ultrasonography parameters differed at the 3 chemotherapy time points tested (all P < .001). The parameters as measured by 3DSTE decreased with an increased cumulative dose of anthracycline drugs, and the values differed at the different time points (all P < .001); the MCI value decreased the most. The serum cTnT concentrations of 9 patients after 4 cycles of chemotherapy were higher than the normal range, and the serum cTnT concentrations differed at the different chemotherapy time points (P < .001). Receiver operating characteristic curve analysis showed that the area under the curve value for MCI was higher than other quantitative parameters of imaging; for MCI, the area under the curve was 0.799, the Youden index was 0.683, the sensitivity was 77.80%, and the specificity was 90.50%.

Conclusion: 3DSTE is helpful for early detection of damage to left ventricular function in patients with breast cancer treated with anthracycline drugs, and MCI is the most sensitive observation index among the parameters tested.