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Single versus standard multiview assessment of global longitudinal strain for the diagnosis of cardiotoxicity during cancer therapy

Thavendiranathan, P, Negishi, T, Cote, M-A, Penicka, M, Massey, R, Cho, G-Y, Hristova, K, Vinereanu, D, Popescu, BA, Izumo, M, Negishi, K ORCID: 0000-0002-9086-2565 and Marwick, TH ORCID: 0000-0001-9065-0899 2018 , 'Single versus standard multiview assessment of global longitudinal strain for the diagnosis of cardiotoxicity during cancer therapy' , JACC: Cardiovascular Imaging, vol. 11, no. 8 , pp. 1109-1118 , doi: 10.1016/j.jcmg.2018.03.003.

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Objectives: The goal of this study was to compare echocardiographic measurements of global longitudinal strain (GLS) (using 3 apical views) with single-view longitudinal strain (LS, 4- or 2-chamber [4CV_LS and 2CV_LS, respectively]) for detection of cancer-therapy related cardiotoxicity.Background: GLS is useful for the detection of cardiotoxicity, but the need for repeated measurements poses a significant burden on busy echocardiography laboratories. A single-view LS measurement, possibly at point of care, could improve efficiency.Methods: Seventeen international centers prospectively recruited 108 patients (mean age 54 ± 13 years) at high risk for cardiotoxicity as part of the ongoing SUCCOUR (Strain Surveillance for Improving Cardiovascular Outcomes During Chemotherapy) randomized controlled trial. Echocardiography performed at baseline and follow-up were analyzed in a core laboratory setting blinded to clinical information. Peak systolic GLS and LS were measured from raw data. Cardiotoxicity was defined by reduction in left ventricular ejection fraction >0.10 to Results: Cardiotoxicity developed in 46 patients by either criteria. Baseline and follow-up 2-dimensional left ventricular ejection fraction were 61 ± 4% and 58 ± 5%, respectively (p Conclusions: Although there was good correlation between GLS and single-view LS measurements, single-view LS measurement led to disagreement in the diagnosis of cardiotoxicity in up to 22% of patients. GLS measurements were more reproducible than single-view LS. GLS based on 3 apical views should remain the preferred technique for detection of cardiotoxicity.

Item Type: Article
Authors/Creators:Thavendiranathan, P and Negishi, T and Cote, M-A and Penicka, M and Massey, R and Cho, G-Y and Hristova, K and Vinereanu, D and Popescu, BA and Izumo, M and Negishi, K and Marwick, TH
Keywords: cancer therapeutics–related cardiac dysfunction, cardiotoxicity, global longitudinal strain, single-view longitudinal strain
Journal or Publication Title: JACC: Cardiovascular Imaging
Publisher: Elsevier Inc.
ISSN: 1936-878X
DOI / ID Number: 10.1016/j.jcmg.2018.03.003
Copyright Information:

Copyright 2018 by the American College of Cardiology Foundation. Published by Elsevier.

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