Role of 3D Echocardiography Strain Analysis in Detecting Cardiotoxicity in Breast Cancer Patients Receiving Chemotherapy

Document Type : Original Article

Authors

1 cardiology department, faculty of medicine , Al-Azhar university

2 cardiology department, faculty of medicine Al-Azhar university

3 Cardiology department , faculty of medicine alazhar University egypt

4 Al-Azhar faculty of medicine for boys Cairo

10.21608/aimj.2025.399225.2602

Abstract

Background: Cardiotoxicity represents a significant challenge for breast cancer patients undergoing anthracycline-based chemotherapy. Improving patient outcomes requires early detection of subclinical cardiac impairment. Three-dimensional speckle-tracking echocardiography (3D-STE) may provide better sensitivity and specificity in the early detection of cardiotoxic effects when compared to traditional two-dimensional global longitudinal strain (2D GLS).
Methods: In this prospective study, 120 female breast cancer patients undergoing anthracycline-based chemotherapy were evaluated with comprehensive clinical, laboratory, and echocardiographic assessments, including both 2D and 3D strain analysis, at baseline, after 2 and 4 chemotherapy cycles, and at 3- and 6-month post-treatment. Cardiotoxicity was defined by international criteria based on changes in GLS and LVEF.
Results: Cardiotoxicity incidence increased over time, reaching 31% at six months, and was significantly higher in patients receiving trastuzumab. At six months, the cardiotoxicity group had significantly impaired diastolic function and lower 2D LVEF. 2D GLS exhibited a significant decline starting from the fourth chemotherapy cycle (AUC=0.76). In contrast, both 3D GLS and 3D GAS demonstrated earlier and more marked decreases, achieving high diagnostic accuracy as early as after two treatment cycles. (3D GLS AUC=0.843; 3D GAS AUC=0.873).
Conclusions: Three-dimensional speckle-tracking echocardiography (3D-STE) is a non-invasive, reproducible modality that demonstrates superior sensitivity and specificity to 2D-GLS for the early detection of cardiotoxicity in breast cancer patients receiving anthracycline chemotherapy.

Keywords

Files

Share

How to cite

Statistics