e11585 Background: Anthracyclines have been widely used in the treatment of solid and hematologic malignancies. Cardiotoxicity is the most serious adverse effect that limits anthracycline treatment. Cardiotoxicity is classified by time of onset as acute, subacute and chronic. Conventional echocardiography is not sensitive enough for early detection of cardiotoxicity. In this study we aimed to evaluate anthracycline induced cardiac toxicity by speckle tracking echocardiography (STE) before left ventricular dysfunction occurs. Methods: The study included newly diagnosed breast cancer (BC) and lymphoma patients (pts) who were treated with an anthracycline containing chemotherapy (CT) regimen. They had examination with conventional echocardiyography, STE before and after anthracycline treatment. Longitudinal strain values were assessed by automated function image (AFI). Results: Thirty five pts with BC and 15 pts with lymphoma were included in the study. Ejection fraction (EF) and fractional shortening values were decreased in lymphoma pts receiving high dose anthracycline treatment (346 mg/m2) compared to BC pts receiving low dose (168 mg/m2) anthracycline. There was statistically significant increase in myocardial performance index in both groups after anthracycline CT (p=0.001 and p=0.004 for BC and lymphoma group respectively). In STE measurements, apical long axis, apikal 4 chamber and global peak systolic strain showed significant reduction in lymphoma group who had a post-therapy EF <55% (p=0.002, p=0.041, and p=0.004, respectively). Apical long axis and global peak systolic strain were also significantly decreased among the lymphoma pts with normal systolic function after CT (p=0.01 and p=0.05, respectively). Conclusions: STE can display the effect of anthracycline induced cardiotoxicity early before left ventricular dysfunction occurs. Larger prospective studies are needed to verify these data and direct the treatment of pts receiving anthracycline.
Totally thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunction