Subclinical ventricular dysfunction detected by speckle tracking two years after use of anthracycline.

Abstract:

BACKGROUND:Heart failure is a severe complication associated with doxorubicin (DOX) use. Strain, assessed by two-dimensional speckle tracking (2D-STE), has been shown to be useful in identifying subclinical ventricular dysfunction. OBJECTIVES:a) To investigate the role of strain in the identification of subclinical ventricular dysfunction in patients who used DOX; b) to investigate determinants of strain response in these patients. METHODS:Cross-sectional study with 81 participants: 40 patients who used DOX ± 2 years before the study and 41 controls. All participants had left ventricular ejection fraction (LVEF) ≥ 55%. Total dose of DOX was 396 mg (242 mg/ms2). The systolic function of the LV was evaluated by LVEF (Simpson), as well as by longitudinal (εLL), circumferential (εCC), and radial (εRR) strains. Multivariate linear regression (MLR) analysis was performed using εLL (model 1) and εCC (model 2) as dependent variables. RESULTS:Systolic and diastolic blood pressure values were higher in the control group (p < 0.05). εLL was lower in the DOX group (-12.4 ± 2.6%) versus controls (-13.4 ± 1.7%; p = 0.044). The same occurred with εCC: -12.1 ± 2.7% (DOX) versus -16.7 ± 3.6% (controls; p < 0.001). The S' wave was shorter in the DOX group (p = 0.035). On MLR, DOX was an independent predictor of reduced εCC (B = -4.429, p < 0.001). DOX (B = -1.289, p = 0.012) and age (B = -0.057, p = 0.029) were independent markers of reduced εLL. CONCLUSION:a) εLL, εCC and the S' wave are reduced in patients who used DOX ± 2 years prior to the study despite normal LVEF, suggesting the presence of subclinical ventricular dysfunction; b) DOX was an independent predictor of reduced εCC; c) prior use of DOX and age were independent markers of reduced εLL.

journal_name

Arq Bras Cardiol

authors

de Almeida AL,Silva VA,de Souza Filho AT,Rios VG,Lopes JR,de Afonseca SO,Cunha Dde C,Mendes MO,Miranda DL,dos Santos Júnior EG

doi

10.5935/abc.20140209

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

274-83

issue

4

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2015000400003

journal_volume

104

pub_type

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