Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography

Background: To examine the subclinical myocardial injury shortly after epirubicin exposure in asymptomatic patients with large B-cell non-Hodgkin lymphoma using 2-dimensional (2D) speckle tracking echocardiography. Methods: Sixty-seven patients aged 52.58 +/- 13.86 years with large B-cell non-Hodgkin lymphoma treated with epirubicin were studied. Echocardiography was performed at baseline and 1 day after completion of the therapy. Global and regional longitudinal (LS), circumferential (CS) and radial strain (RS), standard deviation of time to peak LS (TLS-SD), CS (TCS-SD), RS (TRS-SD) were calculated using 2D speckle tracking echocardiography. Results: Despite normal left ventricular ejection fraction, global LS (-18.30 +/- 1.87% vs. -16.18 +/- 1.92%; p < 0.01), CS (-20.37 +/- 2.89% vs. -18.25 +/- 2.40%, p < 0.01) and RS (39.95 +/- 5.79% vs. 36.15 +/- 5.79%, p < 0.01), were remarkably reduced compared to baseline values. However, TLS-SD, TCS-SD and TRS-SD showed no significant difference after epirubicin exposure. Hypertension was an independent predictor of reduction of global LS, CS and RS. Conclusions: Subtle abnormalities in myocardial systolic function were present in asymptomatic patients shortly after anthracycline exposure, which could be detected by 2D speckle tracking echocardiography.