Results
In our study, 56 patients were enrolled, and two cases were excluded due
to poor image quality. All 54 patients completed anthracycline adjuvant
chemotherapy in our hospital. The
patients were all women age from 29 to 69 years old, none of the
patients had cardiac symptoms, and all patients received
dexrazoxane
during the chemotherapy process. The
cumulative dose during chemotherapy was 483.5 ± 149.0 mg/m2. Three of
the 54 patients began radiotherapy after finished chemotherapy with
anthracyclines. The baseline characteristics of the study population are
presented in Table 1.
According to the standard 2D echocardiography evaluation: there were no
significant changes in the diametral lines of the heart during
chemotherapy; the LVEF
values
and FS values were significantly reduced after six cycles
(P<0.05), although there was a statistically significant
reduction in LVEF after anthracycline therapy, none of the patients had
heart-related symptoms.
In
the echo-Doppler parameters, only the E/e′ ratio
(P<0.05)
was significantly decreased after six cycles, and there was no
significant change in left ventricular diastolic function parameters. Of
note, representing the overall function of the left ventricle TEI index
also was decreased considerably after six cycles (Table 2).
2D STE analyses are shown in Table
2, 3. Compared with the baseline
value, left ventricular global longitudinal strain (GLS) were reduced
significantly after two, four and six cycles (all p<0.05).
Moreover, the decreasing trend was more obvious with the increase of the
dose anthracycline (Table 2). We further discovered that after four
cycles the basal anterior segment (BA) and the apical septal segment
(AS) were altered significantly (all P<0.05); after six cycles
the basal anteroseptal segment (BAS) and apex segment were decreased
significantly (all P<0.05) (Table 2).
The 3D volumetric analyses are shown in
Table 4.
We
found that EDV, ESV, and LVEF were reduced significantly after six
cycles compared to the baseline values (all P<0.05), but all
patients’ LVEF was within the normal range (LVEF>55%).
3D STE analyses are shown in Table 4,5. We found that all 3D strain
parameters were significantly decreased after chemotherapy, GLS has
reduced dramatically after two cycles, especially. Additionally,
compared with baseline values, the basal anterior segment (BA), the
apical septal segment (AS) and the Apex segment were significantly
reduced after two cycles (all P < 0.05); the mid-anterior
segment (MA), the mid-anteroseptal segment (BAS) and the apical lateral
segment (AL) were altered significantly after six cycles (all P
< 0.05). (Figure 3)