Role of 3D Myocardial Strain Imaging in Detecting Chemotherapy Induced Cardiotoxicity in Lymphoma Patients.

Swailam, Ahmed; Al-Almin, Ali Abdelmagid; Al-Habbaa, Ahmed Salah; Al-abbady, Hesham S

doi:10.21608/aimj.2025.401822.2625

Role of 3D Myocardial Strain Imaging in Detecting Chemotherapy Induced Cardiotoxicity in Lymphoma Patients.

Document Type : Original Article

Authors

Al-Azhar faculty of medicine for boys Cairo

10.21608/aimj.2025.401822.2625

Abstract

Background: Three-dimensional (3D) echocardiography has proven to be the most consistent and reliable ultrasound method for assessing left ventricular (LV) volumes and ejection fraction (EF) over a 6-month follow-up in patients receiving chemotherapy for cancer. A key benefit of 3D speckle tracking echocardiography (3D STE) lies in its ability to evaluate the entire LV from a single volumetric dataset, significantly reducing analysis time compared to the more labor-intensive two-dimensional (2D) speckle tracking echocardiography (2D STE).
Aim: To identify subclinical myocardial involvement induced by chemotherapy in patients with lymphoma using 3D speckle tracking echocardiography, and to compare its diagnostic performance with 2D speckle tracking both during treatment and throughout follow-up.
Methods: This prospective observational study enrolled 72 consecutive patients diagnosed with lymphoma, in accordance with established oncology and hematology guidelines, between March 2023 and January 2025. Participants were referred from the Oncology Department at Al-Hussein Hospital and the Tanta Oncology Center. All patients underwent 2D GLS and comprehensive three-dimensional (3D) echocardiographic strain assessments at baseline, during chemotherapy, and six months post-treatment.
Results: 3D strain metrics, particularly 3D global longitudinal strain (3D GLS), have shown superior sensitivity and specificity over 2D GLS in detecting early subclinical LV dysfunction among patients with lymphoma.
Conclusion: All parameters derived from 3D-STE exhibit greater sensitivity and specificity in identifying chemotherapy-induced cardiotoxicity among lymphoma patients. Compared to 2D GLS, 3D-STE enables earlier detection of cardiac dysfunction in this population.

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