Abstract 12440: Global Longitudinal Strain With 2D-Speckle Tracking Predicts Chemotherapy-related Systolic Dysfunction Independenty of Basal Assessment in Patients With Breast Carcinoma

Introduction: Recent developments in anticancer therapies for breast carcinoma allowed an improvement in patient survival, notwithstanding a parallel increase of cardiovascular morbidity. Systolic dysfunction and heart failure represent a relevant problem in these patients due to insidious onset and the potential irreversible nature of cardiac damage. Therefore, strong and early predictors of chemoteraphy-realted systolic dysfunction are been sought. Hypothesis: To investigate global longitudinal strain (GLS) assessed by 2D-speckle tracking as a potential early marker of systolic dysfunction in chemoteraphy-treated breast cancer patients. Methods: Population include sixty-nine patients, referred to our unit for cardiologic assessment prior to neo-adjuvant or adjuvant chemotherapy for breast cancer. Patients with prior heart failure and atrial fibrillation were excluded. The protocol included a baseline echocolorDoppler and 2D-strain evaluation before the beginning of chemotherapy and subsequent serial controls every 3 months. In patients developing systolic dysfunction, further unscheduled assessment were made at the cardiologist discretion. Results: Nineteen (27.5%) patients were classified as having cardiotoxicity according to CREC and ESMO criteria. ROC curve analysis showed that a 3-month GLS Conclusions: Strain imaging with 2D-speckle tracking allows the identification of patients at high risk of developing systolic dysfunction. An absolute cut-off value of -16% can provide a useful, time-independent clinical tool to improve follow-up management and concentrate resources on high-risk patients.