Objective: To investigate the clinical value of two-dimensional speckle tracking echocardiography(2D-STE) combined with high-sensitive cardiac
troponin T (hs-cTnT) in early detection of the
cardiotoxicity induced by
chemotherapy drug. Methods: Seventy-five
non-Hodgkin's lymphoma patients who received the
CHOP regimen were recruited in this study. Conventional echocardiography and 2D-STE were performed on these patients before
chemotherapy, the second day after the third course of
chemotherapy (during
chemotherapy) and the second day after the last course of
chemotherapy (after
chemotherapy). The parameters included left ventricular ejection fraction (LVEF), global longitudinal strain (LS), global circumferential strain (CS) and global radial strain (RS). The serum hs-cTNT levels were tested simultaneously. Results: Three cycles of CHOP were completed in 30 patients and 6-8 cycles of CHOP were completed in 45 patients. The LVEF of 75 patients before, during and after
chemotherapy was (63.8±2.6)%, (63.8±2.8)% and (64.0±3.3)%, respectively, without significant difference (P=0.91). However, the LS of 75 patients before, during and after
chemotherapy was (-18.5±1.7)%, (-16.5±1.9)% and (-16.0±1.6)%, respectively. The CS was (-20.9±2.9)%, (-19.3±3.5)% and (-19.2±3.2)%, respectively. The RS was (39.2±6.4)%, (35.3±5.2)% and (35.0±6.2)%, respectively. The hs-cTnT was (0.001 0±0.002 0)ng/ml, (0.006 3±0.008 9)ng/ml and (0.007 3±0.003 8)ng/ml, respectively. The LS, CS and RS were significantly decreased while hs-cTnT was significantly increased during
chemotherapy when compared to those before
chemotherapy (all of P<0.01). Alternatively, the LS, CS, RS and hs-cTnT after
chemotherapy were marginally different from those during
chemotherapy (all of P>0.05). Moreover, T(LS-SD), T(CS-SD) and T(RS-SD) showed no significant difference before, during and after
chemotherapy (all of P>0.05). The reduction of LS was positively associated with the enhancement of hs-cTnT after
chemotherapy (r=0.60, P<0.01). Conclusion: 2D-STE combined with hs-cTnT can effectively and precisely detect the occult
cardiotoxicity induced by
anthracycline.