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21.11.2020 | Original Paper

Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer

verfasst von: Aviram Hochstadt, Joshua Arnold, Roni Rosen, Chen Sherez, Jack Sherez, Liat Mor, Yonatan Moshkovits, Ilan Merdler, Yishay Szekely, Yaron Arbel, Zach Rozenbaum, Livia Kapusta, Yan Topilsky, Michal Laufer-Perl

Erschienen in: Clinical Research in Cardiology | Ausgabe 4/2021

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Abstract

Background

Diastolic dysfunction is a common finding in patients receiving cancer therapy. This study evaluated the correlation of diastolic strain slope (Dss) with routine echocardiography diastolic parameters and its role in early detection of systolic dysfunction and cardiovascular (CV) mortality within this population.

Methods

Data were collected from the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling adult patient receiving cancer therapy. All patients performed at least three echocardiography exams (T1, T2, T3), including left ventricle Global Longitudinal Strain (LV GLS) and Dss. Systolic dysfunction was determined by either LV GLS relative reduction of ≥ 15% or LV ejection fraction reduction > 10% to < 53%. Dss was assessed as the early lengthening rate, measured by the diastolic slope (delta%/sec).

Results

Among 144 patients, 114 (79.2%) were female with a mean age of 57.31 ± 14.3 years. Dss was significantly correlated with e' average. Mid segment Dss change between T1 and T2 showed significant association to systolic dysfunction development (Odds Ratio (OR) = 1.04 [1.01,1.06]. p = 0.036). In multivariate prediction, Dss increase was a significant predictor for the development of systolic dysfunction (OR = 1.06 [1.03,1.1], P < 0.001).An 8% increase in Dss between T1 and T2 was associated with a trend in increased CV mortality (HR = 3.4 [0.77,15.4], p = 0.085).

Conclusions

This study is the first to use the novel measurement of Dss in patients treated with cancer therapies and to show significant correlation between routine diastolic dysfunction parameters and Dss. Changes in the mid segment were found to have significant independent early predictive value for systolic dysfunction development in univariate and multivariate analyses.

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Titel: Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer
verfasst von: Aviram Hochstadt
Joshua Arnold
Roni Rosen
Chen Sherez
Jack Sherez
Liat Mor
Yonatan Moshkovits
Ilan Merdler
Yishay Szekely
Yaron Arbel
Zach Rozenbaum
Livia Kapusta
Yan Topilsky
Michal Laufer-Perl
Publikationsdatum: 21.11.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 4/2021
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01776-w

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Abstract

Background

Methods

Results

Conclusions

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