To evaluate the utility of global circumferential strain (GCS) as a tool for identifying subclinical cancer therapy-related cardiac dysfunction (CTRCD) in patients undergoing cancer therapy.
Approach:
Study Design: A retrospective study involving 78 patients undergoing cancer therapy with at least 2 echocardiographic examinations.
Patient Selection: Patients had normal baseline left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) values, and were excluded if they had moderate or greater CTRCD.
Comparison: Changes in GCS and GLS were compared between patients who developed mild CTRCD and those who did not.
Key Findings:
No significant differences in mean baseline LVEF (56% vs 58%), GLS (both −19%), or GCS (both −21%) between patients with and without CTRCD.
Mean relative change in GCS was similar to GLS in both groups: −19% for both measures among patients with CTRCD and −5% vs −4%, respectively, among those without CTRCD.
Moderate correlations between GCS and GLS were observed.
Relative reductions of greater than 15% in GCS and GLS were concordant in 92% of patients with CTRCD and 93% of those without.
Interpretation:
The researchers suggest that GCS may serve as an alternative or complementary tool for identifying subclinical CTRCD, especially when GLS assessment is limited.
Limitations:
Mild CTRCD was defined by relative GLS reduction, lacking independent validation against clinical outcomes.
The study was conducted at a single center, limiting generalizability.
GCS measurement is not routinely performed in many echocardiography laboratories, necessitating training for implementation.
Conclusion:
The researchers indicate that further prospective studies are needed to establish the clinical utility and cutoff values for GCS in cardio-oncology.
