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Evolution of echocardiography in subclinical detection of cancer therapy–related cardiac dysfunction
Authors:Rohit Moudgil MD  PhD  Saamir Hassan MD  Nicolas Palaskas MD  Juan Lopez‐Mattei MD  Jose Banchs MD  Syed Wamique Yusuf MD
Affiliation:Department of Cardiology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA
Abstract:Cancer therapies have resulted in increased survivorship in oncological patients. However, the benefits have been marred by the development of premature cardiovascular disease. The current definition outlines measurement of ejection fraction as a mean to diagnose cancer therapeutic–related cardiac dysfunction (CTRCD); however, up to 58% of the patients do not regain their cardiac function after the CTRCD diagnosis, despite therapeutic interventions. Therefore, there has been a growing interest in the markers for early myocardial changes (ie, changes with normal left ventricular ejection fraction [LVEF]) that may predict the development of subsequent left ventricular ejection fraction reduction or progression to heart failure. This review will highlight the use of diastolic parameters, tissue Doppler imaging (TDI), and speckle tracking echocardiogram (STE) as emerging technologies which can potentially detect cardiac dysfunction thereby stratifying patients for cardioprotective therapies. The goal of this manuscript was to highlight the concepts and discuss the current controversies surrounding these echocardiographic imaging modalities.
Keywords:cancer therapy–  related cardiac dysfunction  global longitudinal strain  speckle tracking echocardiogram  strain imaging  tissue Doppler
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