Echocardiography image quality of global longitudinal strain in cardio-oncology: a prospective real-world investigation

• Published in: Journal of echocardiography 2022-09, Vol.20 (3), p.159-165
• Main Authors: Iida, Noriko, Tajiri, Kazuko, Ishizu, Tomoko, Sasamura-Koshizuka, Rumi, Nakajima, Hideki, Kawamatsu, Naoto, Sato, Kimi, Yamamoto, Masayoshi, Machino-Ohtsuka, Tomoko, Bando, Hiroko, Sekine, Ikuo, Kawakami, Yasushi, Ieda, Masaki
• Format: Article
• Language: English
• Subjects: Cardiology; Imaging; Medicine; Medicine & Public Health; Original Investigation; Radiology; Ultrasound
• ISSN: 1349-0222; 1880-344X
• DOI: 10.1007/s12574-022-00567-8

Background Left-ventricular (LV) global longitudinal strain (GLS) has been reported to be a robust and sensitive marker of chemotherapy-induced cardiac damage. Image quality is paramount for accurate GLS measurements. In real-world cardio-oncology settings, the incidence of suboptimal echocardiography quality and its significance in clinical decision-making have not been well investigated. This prospective study examined the incidence and impact of suboptimal echocardiographic image quality on detecting subtle myocardial damage by chemotherapy. Methods Seventy-seven consecutive patients with breast cancer (age, 52 ± 12 years, 76 women, 33 with left-sided breast cancer) were included in this study. Echocardiography was performed at 3-month intervals 1 year before and after chemotherapy initiation. We classified the image quality of each echocardiographic acquisition into three groups: optimal, suboptimal, or inadequate for speckle tracking. Results Among the 376 examinations obtained during the cardiac monitoring, the image quality in 194 (52%) was optimal, suboptimal in 159 (42%), and inadequate in 23 (6%). The interobserver reproducibility was 0.91 in the optimal and 0.21 in the suboptimal group. In contrast, the optimal group showed progressive impairment in both GLS ( p  = 0.001) and LV ejection fraction (LVEF) ( p