Utilidad de las técnicas de deformación miocárdica (strain) para evaluar cardiotoxicidad en pacientes con enfermedades oncológicas y tratamiento quimioterápico

Francisco L. Moreno-Martínez; Samuel Hernández Sarmiento; Cristina V. del Pino Hernández; José A. Gómez Guindal; Carlos E. Rodríguez Camacho

Authors

Francisco L. Moreno-Martínez
Samuel Hernández Sarmiento
Cristina V. del Pino Hernández
José A. Gómez Guindal
Carlos E. Rodríguez Camacho

Abstract

Introduction: Assessment of myocardial function is critical for decision making during the follow-up of patients with oncologic diseases undergoing chemotherapy. Two-dimensional speckle-tracking techniques help to determine the degree of myocardial fiber deformation and provide a more direct measure of systolic function than left ventricular ejection fraction (LVEF)

Objectives: To evaluate myocardial function by means of echocardiography in patients with oncological diseases undergoing chemotherapy.

Method: A prospective longitudinal descriptive study was performed in 21 patients diagnosed with cancer and with indication for chemotherapy with trastuzumab, in the Hospital of Fuerteventura (Spain), between January 2017 and May 2020. All underwent transthoracic echocardiography with speckle-tracking technique (global longitudinal strain) before treatment and during follow-up.

Results: Women (95.2%) with a diagnosis of breast cancer (90.5%) predominated and the mean age was 53.8 years (range 38-75). Left ventricular ejection fraction and global longitudinal strain were normal (100%) before starting chemotherapy. It was necessary to suspend treatment in 3 patients (14.3%); but only in 2 of them (9.5%) due to cardiotoxicity detected by echocardiography. Five patients (23.8%) presented symptoms of heart failure, 1 (4.8%) had cardiotoxicity and in the other 4 (19.0%) the absence of myocardial dysfunction was demonstrated, so that treatment could be continued safely.

Conclusions: Two-dimensional speckle-tracking echocardiography was of vital importance for assessing myocardial performance and guiding chemotherapy in patients with oncologic diseases.

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