<p>Although early detection and prediction of cancer therapy-related cardiac dysfunction (CTRCD) have been widely studied in the literature in breast cancer patients, little is known about the potential predictive role of Tissue Doppler Imaging (TDI) as a risk factor. The purpose of this study is to assess the predictive role of Pulsed-waved TDI in predicting cardiotoxicity in breast cancer patients. In total, 270 breast cancer patients, 27 of whom experienced CTRCD during the follow-up period, were enrolled. Echocardiography was performed at baseline (before the beginning of the treatment), and TDI images were obtained. Other clinical variables were also measured. Significant differences were found between the TDI images of patients who developed cardiotoxicity and those of patients who did not, particularly around the <InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq1.gif" Format="GIF" Height="15" Rendition="HTML" Resolution="72" Type="Linedraw" Width="20" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{E}^{{\prime\:}}\)</EquationSource> </InlineEquation> wave. Specifically, patients with CTRCD had a smoother and later <InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq1.gif" Format="GIF" Height="15" Rendition="HTML" Resolution="72" Type="Linedraw" Width="20" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{E}^{{\prime\:}}\)</EquationSource> </InlineEquation> wave. The variable <InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq3.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="23" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{{E}^{{\prime\:}}}\)</EquationSource> </InlineEquation>, which accounts for both the peak velocity of the <InlineEquation ID="IEq4"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq1.gif" Format="GIF" Height="15" Rendition="HTML" Resolution="72" Type="Linedraw" Width="20" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{E}^{{\prime\:}}\)</EquationSource> </InlineEquation> wave and the timing within the cardiac cycle when this peak is reached, was found to be highly informative. Patients with a <InlineEquation ID="IEq5"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq3.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="23" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{{E}^{{\prime\:}}}\)</EquationSource> </InlineEquation> value above the threshold of 0.052 have a higher risk of CTRCD, which supports its potential as an early indicator of the risk of cardiotoxicity. The <InlineEquation ID="IEq6"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq3.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="23" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{{E}^{{\prime\:}}}\)</EquationSource> </InlineEquation> in the baseline TDI is significantly associated with the CTRCD. Specific characteristics of the <InlineEquation ID="IEq7"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="10554_2025_3439_Article_IEq7.gif" Format="GIF" Height="15" Rendition="HTML" Resolution="72" Type="Linedraw" Width="20" /> </InlineMediaObject> <EquationSource Format="TEX">\({E}^{\prime}\)</EquationSource> </InlineEquation> wave, such as the moment in the cycle when its peak occurs and its velocity, may be used in clinical practice to predict cardiovascular side effects in patients undergoing breast cancer treatment.</p>

Tissue Doppler Imaging as a predictor of therapy-related cardiac dysfunction in breast cancer patients

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2025年6月23日

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Beatriz Piñeiro-Lamas,
Ana López-Cheda,
Ricardo Cao,
Rocío Lesta-Mellid,
Alberto Bouzas-Mosquera,
Cayetana Barbeito-Caamaño

摘要

Although early detection and prediction of cancer therapy-related cardiac dysfunction (CTRCD) have been widely studied in the literature in breast cancer patients, little is known about the potential predictive role of Tissue Doppler Imaging (TDI) as a risk factor. The purpose of this study is to assess the predictive role of Pulsed-waved TDI in predicting cardiotoxicity in breast cancer patients. In total, 270 breast cancer patients, 27 of whom experienced CTRCD during the follow-up period, were enrolled. Echocardiography was performed at baseline (before the beginning of the treatment), and TDI images were obtained. Other clinical variables were also measured. Significant differences were found between the TDI images of patients who developed cardiotoxicity and those of patients who did not, particularly around the \(\:{E}^{{\prime\:}}\) wave. Specifically, patients with CTRCD had a smoother and later \(\:{E}^{{\prime\:}}\) wave. The variable \(\:{v}_{{E}^{{\prime\:}}}\) , which accounts for both the peak velocity of the \(\:{E}^{{\prime\:}}\) wave and the timing within the cardiac cycle when this peak is reached, was found to be highly informative. Patients with a \(\:{v}_{{E}^{{\prime\:}}}\) value above the threshold of 0.052 have a higher risk of CTRCD, which supports its potential as an early indicator of the risk of cardiotoxicity. The \(\:{v}_{{E}^{{\prime\:}}}\) in the baseline TDI is significantly associated with the CTRCD. Specific characteristics of the \({E}^{\prime}\) wave, such as the moment in the cycle when its peak occurs and its velocity, may be used in clinical practice to predict cardiovascular side effects in patients undergoing breast cancer treatment.