ASSESSMENT OF LEFT VENTRICULAR FUNCTION IN PATIENTS UNDERGOING CHEMOTHERAPY BY 2D STRAIN IMAGING

Introduction: Chemotherapy is one of the largest areas of pharmaceutical development. However, the nature of chemotherapy means that while damaging the cancer cells it also damages healthy cells and myocardium is no exception. Cancer patients usually receive a cocktail of chemotherapy drugs, which can result in myocardial injury and left ventricular dysfunction. Echocardiography is the gold standard for assessment of heart function in these patients before, during and after the treatment. In addition Systolic myocardial strain imaging can theoretically detect cardio toxicity early. Objective: Assessment of left ventricular function in patients undergoing chemotherapy by 2D Strain imaging Material & methods: 74 consecutive patients who were subjected for chemotherapy with an age above 18 years were considered for the study. Subjects who had prior structural or functional heart disease, previous history of ischemic heart disease, who underwent percutaneous transluminal angioplasty and/or prior coronary artery bypass grafting, received radiotherapy, LV dysfunction at baseline and with baseline LBBB were excluded from the study. Patients who met the inclusion criteria were subjected for ECHO assessment at baseline and for the second time after completion of the chemotherapy regimen. Data was analyzed by using SPSS software. Results: Out of 74, 49 were females and 25 were males. 8 (10.8%) out of 74 developed reduction of LVEF > 15% at the end of the chemotherapy regimen. In the 2D strain parameters, mean Global longitudinal strain was significantly reduced in post chemotherapy (-19.33?1.75) individuals when compared to mean pre chemotherapy global longitudinal strain (-23.15?2.4) especially in patients who had more than 15% (n=8) drop in their EF. Global Circumferential Strain reduction was not found to be consistent with reduction of LVEF. Conclusion: Strain imaging, Global Longitudinal Strain in particular is ideal for screening and risk profiling of patients undergoing chemotherapy and should be recommended in all patients.