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Screening of Myocardial Cardiotoxicity Induced by Anticancer Chemotherapy and the Importance of global longitudinal strain

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World Journal of Cardiovascular Diseases 2024年第6期14卷 381-391页

作者： Marguerite Téning Diouf Fatou Aw Hussein Khadra Sophie Ba Doudou Diouf Michel Ngonar Sarr Joseph Salvador Mingou Malick Ndiaye Simon Antoine Sarr Momar Dioum Aliou Alassane Ngaide Serigne Mor Beye Simon Manga Alain Affangla Youssou Diouf Khadimu Rassoul Diop Malick Bodian Mohamed Leye Mouhamadou Bamba Ndiaye Alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Cardiology Department of the Dalal Jamm Hospital Dakar Senegal Cardiology Department Hospital Aristide Le Dantec Dakar Senegal Cardiology Department Hospital Fann Dakar Senegal UFR2S Saint Louis Saint Louis Senegal UFR Ziguinchor Ziguinchor Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Cardiology Department Hospital General Idrissa Pouye Dakar Senegal

Introduction: The improvement of survival in patients with cancer and the expansion of therapeutic options have led to the emergence of a new profile of cardiotoxicity, specifically associated with antimitotic agents. Our study aimed to assess the incidence of chemotherapy-induced myocardial toxicity in patients with cancer. Patients and Methods: We conducted a looking-forward longitudinal cohort study including all patients admitted to the Cardiology departments of Aristide le Dantec Hospital and Dalal Jamm National Hospital Centre for apre-chemotherapy check-up. The included patients did not undergo any pre-existing cardiopathy. Results: Over a period of two years ranging from January 2019 to December 2021, a total of 37 patients were included in the study. Notably, there was a female predominance (92%) with an average age of 49.7 years ± 13.69. Breast cancer accounted for 70% of the neoplasms. Laboratory findings revealed moderate anemia in 19 patients (51%). At inclusion, the left ventricle (LV) was of normal size (LV diastole at 44.46 ± 4.97 mm). The systolic function of the left ventricle was normal in all patients, with an average ejection fraction (EF) of 63.1% ± 5.80 and a mean global longitudinal strain (GLS) of −20.4% ± 2.58. The most commonly used agents were anthracyclines. During follow-up, 3 patients (8.1%) developed clinical symptoms of left heart failure, and LV dysfunction on echocardiography was observed in 5 (13.5%) patients, with a significant decrease in EF Conclusion: The incidence of cardiac toxicity is not negligible, hence the importance of early screening. strain imaging is an essential tool that should be performed as part of the assessment before chemotherapy and re-evaluated during treatment.

关键词： Cancer Chemotherapy global longitudinal strain Cardiotoxicity

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global longitudinal strain at Rest for Detection of Coronary Artery Disease in Patients without Diabetes Mellitus

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Current Medical Science 2018年第3期38卷 413-421页

作者： Hou-juan ZUO Xiu-ting YANG Qi-gong LIU Yan ZHANG He-song ZENG Jiang-tao YAN Dao-wen WANG Hong WANG Department of Cardiology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Department of Cardiology Binzhou Medical University Hospital Binzhou 256600 China

global longitudinal strain （GLS） at rest on two-dimensional speckle tracking echocardiography （2D STE） was demonstrated to help detect coronary artery disease （CAD）. However, the optimal cut-off point of GLS and its diagnostic power for detecting critical CAD in non-diabetes mellitus （DM） patients are unknown. In the present study, 211 patients with suspected CAD were prospectively included, with DM patients excluded. All patients underwent echocardiography and subsequently coronary angiography within 3 days. Left ventricular （LV） GLSs were quantified by 2D STE. Territorial peak systolic longitudinal strains （TLSs） were calculated based on the perfusion territories of the 3-epicardial coronary arteries in a 17-segment LV model. Critical CAD was defined as an area stenosis _〉70% in _〉1 epicardial coronary artery （_〉50% in left main coronary artery）. Totally 145 patients were diagnosed as having critical CAD by coronary angiography. Significant differences were observed in all strain parameters between patients with and without critical CAD. The area under the receiver operating charcteristic （ROC） curve （AUC） for GLS in the detection of left main （LM） or threevessel CAD was 0.875 at a cut-off value of-19.05% with sensitivity of 78.1% and specificity of 72.7%, which increased to 0.926 after exclusion of apical segments （cut-off value -18.66%; sensitivity 84.4% and specificity 81.8%）. The values of TLSs were significantly lower in regions supplied by stenotic arteries than in those by non-stenotic arteries. The AUC for the TLSs to identify critical stenosis of left circumflex （LCX） artery, left anterior descending （LAD） artery and right coronary artery （RCA）, in order of diagnostic accuracy, was 0.818 for LCX, 0.764 for LAD and 0.723 for RCA, respectively. In conclusion, in non-DM patients with suspected CAD, GLS assessed by 2D STE is an excellent predictor for LM or three-vessel CAD with high diagnostic accuracy, and a higher cut-off point than reported before should

关键词： two-dimensional strain coronary heart disease global longitudinal strain territorial longitudinal strain

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global longitudinal strain is superior to ejection fraction for detecting myocardial dysfunction in end-stage renal disease with hyperparathyroidism

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World Journal of Cardiology 2022年第4期14卷 239-249页

作者： Maria Fernanda Carrasco-Ruiz Antonio Ruiz-Rivera Marvin A Soriano-Ursúa Carlos Martinez-Hernandez Leticia Manuel-Apolinar Carmen Castillo-Hernandez Gustavo Guevara-Balcazar Eunice D Farfán-García Ana Mejia-Ruiz Ivan Rubio-Gayosso Teresa Perez-Capistran Department of Physiology Escuela Superior de MedicinaInstituto Politécnico NacionalCiudad de México 11340Mexico Department of Cardiology Instituto Mexicano del Seguro SocialCiudad de México 06720Mexico Endocrine Research Unit Instituto Mexicano del Seguro SocialCiudad de México 06720Mexico Department of Cardiovascular Pharmacology Instituto Politécnico NacionalCiudad de México 11340Mexico Department of Biochemistry Escuela Superior de MedicinaInstituto Politécnico NacionalCiudad de México 11340Mexico Education Research Comisión Nacional Para la Mejora Continua de la EducaciónCiudad de México 03900Mexico Postgraduate Studies and Research Section Escuela Superior de MedicinaInstituto Politécnico NacionalCiudad de México 11340Mexico Department of Physiology Instituto Politécnico NacionalMexico City 11340Ciudad de MéxicoMexico

BACKGROUND The estimation of left ventricular ejection fraction(LVEF)by 2D echocardiography(2D-ECHO)is the most used tool to assess LV systolic function(LVSF).global longitudinal strain(GLS)has recently been suggested as a superior method for several *** study explored the association and prevalence of LV systolic dysfunction(LVSD)by using these methods in patients with end-stage renal disease(ESRD)and severe hyperparathyroidism(SHPTH);both associated with cardiovascular events(CEs).AIM To evaluate the myocardial function in patients with ESRD and SHPTH by using the GLS and LVEF measured through conventional *** In 62 patients with ESRD and SHPTH,asymptomatic,and without a history of CEs,LVSF was evaluated by 2D-ECHO,obtaining the EF,by the Simpson biplane method,and GLS by speckle *** The total patients with ESRD had a preserved LVEF(>50%)but abnormal GLS(<13.55%).Additionally,multivariate analysis showed an independent association of GLS and serum parathyroid hormone(PTH),LV mass index,and ***,PTH was independently associated with lateral e'wave and tricuspid regurgitation *** In patients with SHPTH linked to ESRD,the use of GLS by 2D-ECHO is a more sensitive tool than LVEF for detecting LVSD.

关键词： Left ventricular hypertrophy Systolic dysfunction global longitudinal strain End-stage renal disease Parathormone

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Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery

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Journal of Geriatric Cardiology 2018年第8期15卷 519-522页

作者： Matteo Briguglio Luigi Gianturco Daniele Stellat Chiara Colombo Marika Bonadies Oscar Salat Mauro Anselmi Giuseppe Banff Maurizio Turiel Cardiology Unit IRCCS Orthopaedic Institute Galeazzi Milan Italy Scientific Direction IRCCS Orthopaedic Institute Galeazzi Milan Italy University Vitae Salute San Raffaele Milan Italy

Background Cardiovascular diseases and insufficient levels of vitamin D are risk factors for adverse surgical outcomes, and they are both commonly present among older adults undergoing orthopaedic surgery. Giving the cardiovascular effects of vitamin D, pre-operative diagnosis of hypovitaminosis D would be a valuable step for the implementation of supplementation protocols. We investigated if the nor- malization of serum 25 [OH] D could ameliorate cardiac performance of older adults suffering from cardiovascular diseases. Methods We enrolled 47 older adults scheduled for major orthopaedic surgery and suffering from hypovitaminosis D. Patients underwent 6-months cal- cifediol supplementation with a starting dose at first post-operative day of 50 ~tg/die in liquid preparation. Down-titration to 20 Ixg/die at 3-months assessment was planned. Cardiac performance was evaluated by measuring left ventricular ejection fraction （LVEF） and global longitudinal strain （GLS） during pre-operative assessments and at 1-month, 3-months, 6-months follow-ups. Results Six months of cal- cifediol supplementation were associated with a significant improvement of both LVEF （＋ 3.94%; 95% CI： -4.0789 to -0.8232; P 〈 0.01） and GLS （＋ 18.56%; Z = -5.895; P 〈 0.0001）. Conclusions Calcifediol supplementation normalized serum 25 [OH] D concentration after 1-month treatment. GLS offered better insights into myocardial contractile amelioration than LVEF, thus being useful for detecting earlier subclinical changes that may anticipate hemodynamic modifications.

关键词： global longitudinal strain Left ventricular ejection fraction Orthopedic surgery Transthoracic echocardiography Vitamin D

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Evaluation of left ventricular systolic function in type 2 diabetes mellitus patients with and without peripheral vascular disease

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World Journal of Diabetes 2024年第6期15卷 1280-1290页

作者： Guang-An Li Jun Huang Li Fan Department of Echocardiography The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina

BACKGROUND Peripheral vascular disease(PVD)is a common complication of type 2 diabetes mellitus(T2DM).Patients with T2DM have twice the risk of PVD as nondiabetic *** To evaluate left ventricular(LV)systolic function by layer-specific global longitudinal strain(GLS)and peak strain dispersion(PSD)in T2DM patients with and without *** Sixty-five T2DM patients without PVD,57 T2DM patients with PVD and 63 normal controls were enrolled in the ***-specific GLS[GLS of the epimyocardium(GLSepi),GLS of the middle myocardium(GLSmid)and GLS of the endocardium(GLSendo)]and PSD were *** operating characteristic(ROC)analysis was performed to calculate the sensitivity and specificity of LV systolic dysfunction in T2DM patients with *** calculated Pearson’s correlation coefficients between biochemical data,echocardiographic characteristics,and layer-specific GLS and *** There were significant differences in GLSepi,GLSmid and GLSendo between normal controls,T2DM patients without PVD and T2DM patients with PVD(PT2DM patients without PVD>T2DM patients with PVD in the absolute value of GLS(P<0.001).PSD differed significantly between the three groups,and the trend ranking was as follows:normal controls

关键词： Type 2 diabetes mellitus Peripheral vascular disease Speckle tracking echocardiography global longitudinal strain Peak strain dispersion

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Subclinical impairment of left ventricular myocardium function in type 2 diabetes mellitus patients with or without hypertension

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World Journal of Diabetes 2024年第6期15卷 1272-1279页

作者： Zeng-Guang Chen Guang-An Li Jun Huang Li Fan Department of Cardiology The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina Department of Echocardiography The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina

BACKGROUND Cardiovascular disease has been the leading cause of morbidity and mortality for type 2 diabetes mellitus(T2DM)patients over the last *** To determine whether layer-specific global longitudinal strain(GLS)combined with peak strain dispersion(PSD)can be used to assess left ventricle(LV)myocardium systolic dysfunction in T2DM patients or without hypertension(HP).METHODS We enrolled 97 T2DM patients,70 T2DM+HP patients and 101 healthy ***-specific GLS and PSD were calculated by EchoPAC software in apical three-,four-and two-chamber *** of the epimyocardial,middle-layer and endomyocardial(GLSepi,GLSmid,and GLSendo)were measured and *** operating characteristic analysis was performed to detect LV myocardium systolic dysfunction in T2DM *** There were significant differences in GLSepi,GLSmid,GLSendo,and PSD between healthy subjects,T2DM patients and T2DM patients with HP(PT2DM patients>T2DM with HP patients in the absolute values of GLSepi,GLSmid and GLSendo(P<0.001),while PSD was ranked healthy subjects

关键词： Type 2 diabetes mellitus Hypertension Speckle tracking echocardiography global longitudinal strain Peak strain dispersion

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Speckle-tracking echocardiography for detecting myocardial dysfunction in sepsis and septic shock patients:A single emergency department study

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World Journal of Emergency Medicine 2022年第3期13卷 175-181页

作者： Xuan Fu Xue Lin Samuel Seery Li-na Zhao Hua-dong Zhu Jun Xu Xue-zhong Yu Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Faculty of Health and Medicine Division of Health ResearchLancaster UniversityLancaster LAI 4YWUnited Kingdom

BACKGROUND:Septic cardiomyopathy(SCM)occurs in the early stage of sepsis and septic shock,which has implications for treatment strategies and ***,myocardial involvement in the early stages of sepsis is difficult to ***,we assess subclinical myocardial function using laboratory tests and speckle-tracking echocardiography(STE).METHODS:Emergency department patients diagnosed with sepsis or septic shock were included for *** with other causes of acute or pre-existing cardiac dysfunction were *** echocardiography(TTE),including conventional echocardiography and STE,were performed for all patients three hours after initial *** for laboratory tests were taken around the time of ***:Left ventricular functions of 60 patients were analyzed,including 21 septic shock patients and 39 sepsis *** was no significant difference in global longitudinal strain(GLS),global circumferential strain(GCS),or global radical strain(GRS)between patients with sepsis and septic shock(all with P>0.05).However,GLS and GCS were significantly less negative in patients with abnormal troponin levels or in patients with abnormal left ventricular ejection fraction(LVEF)values(all with P<0.05).There were also moderate correlations between GLS and levels of cTnI(r=0.40,P=0.002)or N-terminal pro-B-type natriuretic peptide(NT-proBNP)(r=0.44,P=0.001)in sepsis and septic shock ***:Myocardial dysfunction,e.g.,lower LVEF or less negative GLS in patients with sepsis or septic shock,is more affected by myocardial *** could be incorporated into mainstream clinical practice as a supplementary LVEF parameter,especially for those with elevated troponin levels.

关键词： Sepsis Septic shock Speckle-tracking echocardiography global longitudinal strain global circumferential strain

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Temporal echocardiography findings in patients with fulminant myocarditis: beyond ejection fraction decline

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Frontiers of Medicine 2020年第3期14卷 284-292页

作者： Houjuan Zuo Rui Li Fei Ma Jiangang Jiang Kun Miao Haojie Li Eike Nagel Marijana Tadic Hong Wang Dao Wen Wang Division of Cardiology Department of Internal MedicineTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders Wuhan 430030China Department of Radiology Tongji Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Institute for Experimental and Translational Cardiovascular Imaging DZHK Centre for Cardiovascular ImagingUniversity Hospital Frankfurt/MainFrankfurtGermany Department of Internal Medicine and Cardiology Charité-Universit(a)tsmedizin BerlinAugustenburgerplatz 113353 BerlinGermany

The features of myocardial strains from speckle-tracking echocardiography (STE) have not been well defined in fulminant myocarditis (FM) *** this study,changes in the left ventricular ejection fraction (LVEF) and global and layer-specific myocardial strains over time were *** aimed to determine the echocardiographic patterns of FM and ascertain their significance in FM *** patients who were clinically diagnosed with FM and received mechanical life support were prospectively *** echocardiographic measurements were obtained,and serial strain echocardiography was performed from admission to hospital discharge until LVEF recovery (> 50%).global/regional peak systolic longitudinal strains (GLS/RLS) and layer-specific longitudinal strains were quantified,and their changes with time were monitored in 14 FM *** patients had severely impaired cardiac *** improvement in LVEF and GLS were observed within 6 ***-specific strain analysis showed that reduction at admission or recovery at discharge in the endocardium and epicardium strains were *** conclusion,FM patients who received mechanical circulatory supports exhibited steep improvement in ventricular function within 6 *** patchy and diffused distribution pattern of reduced RLS and equally and severely impaired strain in the endocardium and epicardium are valuable features in the diagnosis of FM.

关键词： fulminant myocarditis acute myocarditis 2D speckle tracking echocardiography left ventricular function global longitudinal strain

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Long Term Follow-Up of Cardiotoxicity in Breast Cancer Treatment: A Case Report

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World Journal of Cardiovascular Diseases 2023年第3期13卷 130-137页

作者： Jose Luis Siller-Nava Adrian Espejel-Guzman Javier Serrano-Roman Aldo Cabello-Ganem Alexis D. Aparicio Ortiz Nilda Espinola-Zavaleta Department of Nuclear Cardiology National Institute of Cardiology Ignacio Chavez Mexico City Mexico Mexican Social Security Institute IMSS Mexico City Mexico Department of Echocardiography ABC Medical Center I.A.P. Mexico City Mexico

Background: Cardiac toxicity is currently defined as a symptomatic decrease in Left Ventricular Ejection Fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated evaluations on conventional transthoracic echocardiogram (TTE), as well as a global longitudinal strain (GLS) value Aims: To highlight using GLS rather than modified Simpson 2D-LVEF for the evaluation of long-term cardiotoxicity. Case Presentation: The case concerns a 73-year-old female patient with a history of breast cancer chemotherapy and anthracyclines-based therapy who presented symptoms of late cardiac toxicity related to the chemotherapeutic treatment. In the following years, the patient remained asymptomatic with a 2D-LVEF of 48%, dilation of the left atrium was found, and the reservoir phase strain was severely decreased. Conclusion: The preferred method for evaluating cardiovascular complications associated with chemotherapy is the TTE, which is performed prior to the start of treatment, during therapy, and in the follow-up. Myocardial deformation as a predictor of cardiotoxicity allows the identification of subclinical heart failure.

关键词： Cardiotoxicity Breast Cancer global longitudinal strain Left Ventricular Ejection Fraction Heart Failure

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The effect of spironolactone on the levels of GATA4 protein and hypoxia inducible factor-1α in patients receiving coronary stent implantation

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Journal of Chinese Pharmaceutical Sciences 2022年第2期31卷 134-141页

作者： Yumei Lou Xiaoying Ge Zhelan Zheng Linyuan Xie Jiangfang Lian Wenjun Shen Kenan Lou Wanying Hu Dexing Hu Department of Cardiovascular Disease Ningbo Medical Centre Lihuili HospitalNingbo 315000ZhejiangChina Ningbo University Ningbo 315000ZhejiangChina Echocardiography and Vascular Ultrasound Center Ningbo Medical Centre Lihuili HospitalNingbo 315000ZhejiangChina Echocardiography and Vascular Ultrasound Center the First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310000China

In the present study,we aimed to explore the protective effect of spironolactone on cardiac function in patients undergoing coronary stent implantation by determining the serum levels of GATA4 and hypoxia-inducible factor-1α(HIF-1α)proteins before and after the coronary stent implantation.A total of 134 patients undergoing coronary stent implantation in our hospital from March 2019 to March 2020 were retrospectively selected using the propensity score matching(PSM)*** the 134 patients,67 patients taking spironolactone were used as a test group,and the other 67 patients without taking spironolactone were used as a control *** all patients,the levels of serum GATA4,HIF-1α,and troponin I proteins were determined before as well as 24 h and 6 months after the coronary stent *** ventricular ejection fraction(LVEF)and left ventricular systolic global longitudinal strain(GLS)were determined before and 6 months after the coronary stent *** were no significant differences in the HIF-1αlevel between the two groups before and 6 months after the operation,while the HIF-1αlevel was significantly lower in the test group compared with the control group at 24 h after the operation(P<0.01).There were no significant differences in the GATA4 protein level between the two groups before and 24 h after the operation,while the GATA4 protein level was significantly lower in the test group compared with the control group at 6 months after the operation(P<0.01).There was no significant difference in LVEF between the two groups before and 6 months after the *** was significantly improved at 6 months after the operation compared with that before the operation in both groups,while GLS was significantly better in the test group compared with the control group at 6 months after the operation(P<0.01).Collectively,spironolactone could protect cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.

关键词： Coronary stent implantation Spironolactone Hypoxia-inducible factor-1α GATA4 protein Ischemic cardiomyopathy global longitudinal strain

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