Possibilities of preclinical diagnosis of anthracycline cardiotoxicity using the technique of "speckle-tracking echocardiography"

Abstract

In case of antitumour anthracyclines therapy of patients with non-Hodgkin lymphomas the possibility of using speckle-tracking echocardiography is being considered. It was found that patients with non-Hodgkin lymphomas have early violations of the left ventricular myocardium during the course of antitumor chemotherapy using anthracyclines. They are characterized by reducing of longitudinal deformation of the myocardium with a gradual spread from the apical to the basal segments of the left ventricle. A statistically significant reduction in global and segmental systolic deformation after the 4th course of chemotherapy (cumulative dose of doxorubicin 333.5 88.5 mg/m2) is the earliest marker of left ventricular mechanical dysfunction, appearing before the development of diastolic dysfunction and ejection fraction reduction of the left ventricular. Early violations of myocardial mechanics in the dynamics of the course of antitumour therapy with anthracyclines are identified in the apical area of the left ventricle, it can be connected with circulatory failure in this area. Violations of myocardial mechanics in the apical area of the left ventricle can be an erly predictor of ischemia of this area with possible progression to global contractile muscle dysfunction of the left ventricular. The global longitudinall deformation of the left ventricular myocardium in contrast to ejection fraction of the left ventricular is more sensitive to myocardial damages against the backdrop of chemotherapy using anthracyclines. So, it can be used as an early preclinical marker of myocardial damage, that takes echocardiography closer to the most advanced methods of myocardial visualization.