This study was approved by the Fudan University Shanghai Cancer Center
(1212117-6) and Zhongshan Hospital Research Ethics Committee. We
identified 149 consecutive patients with pathologically
confirmed
diffuse large B-cell lymphoma at Fudan University Shanghai Cancer Center
who underwent echocardiography with strain measurements between January
2013 and January 2015. All patients received 4-8 cycles of R-CHOP
therapy (cyclophosphamide 750 mg/m2; vincristine 1.4 mg/m2 up to a
maximum dose of 2 mg/m2; doxorubicin 50 to 70 mg/m2 on day 1; prednisone
100 mg on days 1 to 5; and rituximab 375 mg/m2 every 21 days). We
excluded patients with uncontrolled hypertension (n=1), renal or hepatic
dysfunction(n=1), significant valvular disease (n=2), congenital
disease(1), a widened QRS complex on surface ECG(n=1), arrhythmia (n=4),
a previous history of heart failure and/or CAD (n=1) and
noncardiac death (malignancy or
complication linked to malignancy, n=25), patients with
overall poorly tracking strain
studies (n=17). The study population thus comprised 96 identified
patients who underwent echocardiography examination before the
commencement of chemotherapy and after the completion of chemotherapy
(Figure 1).