PMID- 35839035
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20220719
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 101
IP  - 28
DP  - 2022 Jul 15
TI  - Echocardiographic predictors of symptomatic cardiotoxicity among patients 
      undergoing chemotherapy: A systematic review and meta-analysis.
PG  - e29562
LID - 10.1097/MD.0000000000029562 [doi]
AB  - BACKGROUND: Chemotherapeutic agents have been associated with cardiotoxicity; 
      thus, they require close monitoring. Several echocardiographic variables have 
      been investigated as early predictors of symptomatic cardiotoxicity in patients 
      undergoing chemotherapy. OBJECTIVE: To identify if global longitudinal strain 
      (GLS) is a better predictor of symptomatic cardiotoxicity compared to left 
      ventricular ejection fraction (LVEF) in patients receiving chemotherapy. METHODS: 
      MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched 
      from inception through December 2020. Adults who developed symptomatic 
      cardiotoxicity (New York Heart Association [NYHA] Class III-IV heart failure, 
      cardiac arrest, or cardiac death) after undergoing chemotherapy with pre- and 
      postchemotherapy echocardiographic measures of cardiac function were included. 
      The primary focus was on the prediction of symptomatic cardiotoxicity. Estimates 
      were reported as random effects hazard ratios (HR) with 95% confidence intervals 
      (CI). RESULTS: Four studies met inclusion criteria. The most common malignancy 
      identified in the included studies was breast cancer, and the most common 
      chemotherapeutic agent utilized was anthracyclines. Most studies utilized the 
      Simpson biplane method to measure echocardiographic parameters. Pooled results 
      demonstrated no significant association between LVEF and the prediction of 
      symptomatic cardiotoxicity (HR 1.48; 95% CI, 0.96-2.27; P = 0.07). However, 2 
      studies that analyzed GLS found it to be a strong predictor of symptomatic 
      cardiotoxicity (HR 1.46; 95% CI, 1.34-1.58; P < .001). There was no significant 
      association between symptomatic cardiotoxicity and baseline left ventricular end 
      diastolic volume, end systolic volume, or end diastolic volume index. 
      CONCLUSIONS: GLS may predict symptomatic cardiotoxicity and be used to monitor 
      patients on chemotherapy for symptomatic cardiac dysfunction. While the pooled 
      results for baseline LVEF identified that it is not a predictor of symptomatic 
      cardiotoxicity, this differs from the findings of the only randomized trial 
      included in this meta-analysis. The data for baseline GLS as a predictor of 
      symptomatic cardiotoxicity is encouraging, but definite evidence that GLS may be 
      superior to LVEF is lacking. Prospective randomized, blinded trials are required 
      to identify if 1 echocardiographic parameter may be superior to the other.
CI  - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Siddiqui, Muhammad Umer
AU  - Siddiqui MU
AUID- ORCID: 0000-0001-5375-8702
AD  - Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.
FAU - Yaacoub, Youssef
AU  - Yaacoub Y
AD  - Internal Medicine, Catholic Medical Center, Manchester, NH.
FAU - Hanson, Heidi-Anne
AU  - Hanson HA
AD  - Internal Medicine, Lake Region General Hospital, Laconia, NH.
FAU - Junarta, Joey
AU  - Junarta J
AD  - Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.
FAU - Pasha, Ahmed K
AU  - Pasha AK
AD  - Vascular Medicine, Mayo Clinic Health System, Rochester, MN.
FAU - Shah, Mahek
AU  - Shah M
AD  - Cardiovascular Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220715
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adult
MH  - *Antineoplastic Agents/therapeutic use
MH  - *Breast Neoplasms/drug therapy
MH  - Cardiotoxicity/complications/etiology
MH  - Echocardiography/methods
MH  - Female
MH  - Humans
MH  - Prospective Studies
MH  - Stroke Volume
MH  - *Ventricular Dysfunction, Left/chemically induced/complications/diagnostic 
      imaging
MH  - Ventricular Function, Left
COIS- The authors have no funding and conflict of interest to declare.
EDAT- 2022/07/16 06:00
MHDA- 2022/07/20 06:00
CRDT- 2022/07/15 12:06
PHST- 2022/07/15 12:06 [entrez]
PHST- 2022/07/16 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
AID - 00005792-202207150-00048 [pii]
AID - 10.1097/MD.0000000000029562 [doi]
PST - epublish
SO  - Medicine (Baltimore). 2022 Jul 15;101(28):e29562. doi: 
      10.1097/MD.0000000000029562.