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Longitudinal Diastolic strain as predictor for systolic dysfunction among patients with active breast cancer
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  • Aviram Hochstadt,
  • Joshua Arnold ,
  • Roni Rosen,
  • Chen Sherez,
  • Jack Sherez,
  • Liat Mor,
  • Matthew Derakhshesh,
  • Yonatan Moshkovits,
  • Ilan Merdler,
  • Yaron Arbel,
  • Zach Rozenbaum ,
  • Yan Topilsky,
  • Michal Laufer Perl
Aviram Hochstadt
Tel Aviv University Sackler Faculty of Medicine
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Joshua Arnold
Tel Aviv University Sackler Faculty of Medicine
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Roni Rosen
Tel Aviv University Sackler Faculty of Medicine
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Chen Sherez
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Jack Sherez
Tel Aviv Sourasky Medical Center
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Liat Mor
Tel Aviv University Sackler Faculty of Medicine
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Matthew Derakhshesh
Tel Aviv University Sackler Faculty of Medicine
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Yonatan Moshkovits
Tel Aviv University Sackler Faculty of Medicine
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Ilan Merdler
Tel Aviv University Sackler Faculty of Medicine
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Yaron Arbel
Tel Aviv Medical Center
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Zach Rozenbaum
Tel Aviv Sourasky Medical Center
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Yan Topilsky
Tel Aviv Sourasky Medical Center
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Michal Laufer Perl
Tel Aviv Sourasky Medical Center
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Peer review status:UNDER REVIEW

25 May 2020Submitted to Echocardiography
26 May 2020Assigned to Editor
26 May 2020Submission Checks Completed
26 May 2020Reviewer(s) Assigned

Abstract

Background: Although diastolic dysfunction is common among patients treated with cancer therapy, no clear evidence has been shown that it predicts systolic dysfunction. This study evaluated the correlation of longitudinal diastolic strain (Ds) with echocardiography diastolic parameters and to estimate its role in the early detection of cardiotoxicity among patients with active breast cancer. Methods: Data were collected as part of the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling all adult patients referred to the cardio-oncology clinic. All patients with breast cancer, planned for Doxorubicin therapy were included. Echocardiography, including Global longitudinal systolic strain (GLS) and Ds, was assessed at baseline before chemotherapy (T1), during Doxorubicin therapy (T2) and after the completion of Doxorubicin therapy (T3). Cardiotoxicity were determined by GLS relative reduction of ≥15%. Ds was assessed as the time of lengthening =diastolic time (ms) measured. Results: Among 69 patients, 67 (97.1%) were females with a mean age 52±13years. Diastolic strain time measurement was significantly associated with the standard diastolic parameters. Significant GLS reduction was observed in 10 (20%) patients at T3 . Both in a univariate and a multivariate analyses the change in Ds basal time from T1 to T2 emerged to be significantly associated with GLS reduction at T3 (p<0.04). Conclusions: Among breast cancer patients, Ds time showed high correlation to standard diastolic echocardiography parameters. Relative reduction in Ds basal time emerged associated with clinically significant systolic dysfunction as measured by GLS reduction.