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Diastolic strain time as predictor for systolic dysfunction among patients with active breast cancer
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  • Aviram Hochstadt,
  • Joshua Arnold ,
  • Roni Rosen,
  • Chen Sherez,
  • Jack Sherez,
  • Liat Mor,
  • Matthew Derakhshesh,
  • Yonatan Moshkovits,
  • Ilan Merdler,
  • Yaron Arbel,
  • Livia Kapusta,
  • Zach Rozenbaum ,
  • Yan Topilsky,
  • Michal Laufer Perl
Aviram Hochstadt
Tel Aviv University Sackler Faculty of Medicine
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Joshua Arnold
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Roni Rosen
Tel Aviv University Sackler Faculty of Medicine
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Chen Sherez
Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia
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Jack Sherez
Tel Aviv Sourasky Medical Center
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Liat Mor
Tel Aviv University Sackler Faculty of Medicine
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Matthew Derakhshesh
Tel Aviv University Sackler Faculty of Medicine
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Yonatan Moshkovits
Tel Aviv University Sackler Faculty of Medicine
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Ilan Merdler
Tel Aviv University Sackler Faculty of Medicine
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Yaron Arbel
Tel Aviv Medical Center
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Livia Kapusta
Tel Aviv Sourasky Medical Center
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Zach Rozenbaum
Tel Aviv Sourasky Medical Center
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Yan Topilsky
Mayo Clinic
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Michal Laufer Perl
Tel Aviv Sourasky Medical Center
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Peer review status:Published

18 Jun 2020Submission Checks Completed
18 Jun 2020Assigned to Editor
18 Jun 2020Reviewer(s) Assigned
21 Jun 2020Review(s) Completed, Editorial Evaluation Pending
21 Jun 2020Editorial Decision: Revise Minor
24 Jun 20201st Revision Received
24 Jun 2020Submission Checks Completed
24 Jun 2020Assigned to Editor
24 Jun 2020Reviewer(s) Assigned
24 Jun 2020Review(s) Completed, Editorial Evaluation Pending
24 Jun 2020Editorial Decision: Accept
20 Jul 2020Published in Echocardiography. 10.1111/echo.14791

Abstract

Background: Although diastolic dysfunction is common among patients treated with cancer therapy, no clear evidence has been shown that it predicts systolic dysfunction. This study evaluated the correlation of longitudinal diastolic strain time (Dst) with the routine echocardiography diastolic parameters and to estimated its role in the early detection of cardiotoxicity among patients with active breast cancer. Methods: Data were collected as part of the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling all adult patients referred to the cardio-oncology clinic. All patients with breast cancer, planned for Doxorubicin therapy were included. Echocardiography, including Global longitudinal systolic strain (GLS) and Dst, was assessed at baseline before chemotherapy (T1), during Doxorubicin therapy (T2) and after the completion of Doxorubicin therapy (T3). Cardiotoxicity were determined by GLS relative reduction of ≥15%. Dst was assessed as the time measured (ms) of the myocardium lengthening during diastole. =diastolic time (ms) measured. Results: Among 69 patients, 67 (97.1%) were females with a mean age 52±13years. Diastolic strain timeDst measurement was significantly associated with the standard routine diastolic parameters. Significant GLS reduction was observed in 10 (20%) patients at T3 . Both in a univariate and a multivariate analyses the change in Ds basal time from T1 to T2 emerged to be significantly associated with GLS reduction at T3 (p<0.04). Conclusions: Among breast cancer patients, Dst time showed high correlation to standard the routine diastolic echocardiography parameters. Relative reductionChange in Ds basal time emerged associated with clinically significant systolic dysfunction as measured by GLS reduction.