GLOBAL LONGITUDINAL STRAIN AS A PREDICTOR OF CARDIOTOXICITY IN BREAST CANCER PATIENTS RECEIVING ANTHRACYCLINE AND/OR TRASTUZUMAB TREATMENT IN A TERTIARY CARE CENTRE IN EASTERN INDIA

Objectives: The objective of the study was to find out whether global longitudinal strain (GLS) poses as a novel marker of left ventricular (LV) systolic function and it was to be seen whether GLS could predict cardiotoxicity earlier than Ejection fraction (EF). Methods: Fifty-two patients set to receive anthracycline and/or trastuzumab-based chemotherapy for breast carcinoma were selected – clinical parameters and baseline echocardiography (EF, E/e,’ LV S,’ Tricuspid annular plane systolic excursion, Pulmonary artery systolic pressure and GLS) were measured and followed up at 3 months and 6 months. The echocardiography profiles of patients with and without cardiotoxicity were compared. Results: Incidence of cardiotoxicity is found 11.5%. On 3rd month, the mean LV GLS, as well as its difference regarding the baseline value, were significantly higher in the group with cardiotoxicity in comparison to those without cardiotoxicity. On 6th month, there was a significant drop in the EF and LV GLS, E/e’, and LV s’ in the patients with cardiotoxicity. LV GLS on the 3rd month remained an independent predictor of cardiotoxicity, maintaining a statistically significant association in multivariate models. Conclusion: GLS is indeed a more sensitive marker of LV systolic functions than EF. It predicted cardiotoxicity earlier than EF and accurately. This study also provided a cutoff value for LV GLS at 3 months in predicting who would develop cardiotoxicity at 6 months, so that the chemotherapy regimen could be modified in such patients.