Abstract 16408: Torsion Analysis in the Early Detection of Anthracycline Mediated Cardiomyopathy
Background: Cardiotoxicity induced by anthracycline drugs is very serious, irreversible and limits the therapeutic potential in many patients undergoing cancer chemotherapy. A preventive strategy may be the early detection of subclinical cardiotoxic effects, followed by low dose of anthracyclines. The aim of this study was to determine if sensitive indices of left ventricular (LV) dysfunction, especially torsion analysis using two-dimensional speckle tracking imaging (STI), would be useful for addressing the early detection of anthracycline-mediated cardiotoxicity.
Methods: Twenty five patients (mean age 58 ± 11 years) were enrolled in this study. Conventional and Doppler echocardiography were obtained before chemotherapy, 1 month and 3 months after the treatment. The cumulative doses of doxorubicin were 125 ± 113 mg/m2 at 1 month and 198 ± 120 mg/m2 at 3 months. After a standard echocardiographic examination, LV torsion and twisting velocity profiles from apical and basal short-axis images were analyzed using STI.
Results: LV dimensions and ejection fraction did not change throughout the follow-up. Although isovolumic relaxation time showed prolongation 3 months after the chemotherapy, other Doppler indices did not show significant changes after the chemotherapy. In contrast, a significant reduction in torsion (before, 11 ± 4 degrees; 1 month, 7 ± 3 degrees; 3 months, 6 ± 3 degrees; p<0.0001 by ANOVA), twisting rate (before, 85 ± 14 deg/sec; 1 month, 64 ± 18 deg/sec; 3 months, 63 ± 16 deg/sec; p<0.0001 by ANOVA), and untwisting rate (before, 113 ± 26 deg/sec; 1 month, 90 ± 27 deg/sec; 3 months, 81 ± 31 deg/sec; p<0.001 by ANOVA) were found 1month after the chemotherapy.
Conclusion: LV torsion analysis is a sensitive and useful noninvasive approach for evaluating subclinical anthracycline cardiotoxicity.
- © 2010 by American Heart Association, Inc.