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Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer

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Abstract

Background

Diastolic dysfunction is a common finding in patients receiving cancer therapy. This study evaluated the correlation of diastolic strain slope (Dss) with routine echocardiography diastolic parameters and its role in early detection of systolic dysfunction and cardiovascular (CV) mortality within this population.

Methods

Data were collected from the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling adult patient receiving cancer therapy. All patients performed at least three echocardiography exams (T1, T2, T3), including left ventricle Global Longitudinal Strain (LV GLS) and Dss. Systolic dysfunction was determined by either LV GLS relative reduction of ≥ 15% or LV ejection fraction reduction > 10% to < 53%. Dss was assessed as the early lengthening rate, measured by the diastolic slope (delta%/sec).

Results

Among 144 patients, 114 (79.2%) were female with a mean age of 57.31 ± 14.3 years. Dss was significantly correlated with e' average. Mid segment Dss change between T1 and T2 showed significant association to systolic dysfunction development (Odds Ratio (OR) = 1.04 [1.01,1.06]. p = 0.036). In multivariate prediction, Dss increase was a significant predictor for the development of systolic dysfunction (OR = 1.06 [1.03,1.1], P < 0.001).An 8% increase in Dss between T1 and T2 was associated with a trend in increased CV mortality (HR = 3.4 [0.77,15.4], p = 0.085).

Conclusions

This study is the first to use the novel measurement of Dss in patients treated with cancer therapies and to show significant correlation between routine diastolic dysfunction parameters and Dss. Changes in the mid segment were found to have significant independent early predictive value for systolic dysfunction development in univariate and multivariate analyses.

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Authors and Affiliations

  1. Department of Cardiology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel

    Aviram Hochstadt, Jack Sherez, Ilan Merdler, Yishay Szekely, Yaron Arbel, Zach Rozenbaum, Yan Topilsky & Michal Laufer-Perl

  2. Pediatric Cardiology Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel

    Livia Kapusta

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Aviram Hochstadt, Joshua Arnold, Roni Rosen, Jack Sherez, Liat Mor, Yonatan Moshkovits, Ilan Merdler, Yishay Szekely, Yaron Arbel, Zach Rozenbaum, Livia Kapusta, Yan Topilsky & Michal Laufer-Perl

  4. Department of Pediatrics Cardiology, Amalia Children’s Hospital, Radboud University Medical Centre, Nijmegen, The Netherlands

    Livia Kapusta

  5. University of Naples, Federico ll, Naples, Italy

    Chen Sherez

Authors
  1. Aviram Hochstadt
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  2. Joshua Arnold
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Correspondence to Michal Laufer-Perl.

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Hochstadt, A., Arnold, J., Rosen, R. et al. Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer. Clin Res Cardiol 110, 569–578 (2021). https://doi.org/10.1007/s00392-020-01776-w

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  • DOI: https://doi.org/10.1007/s00392-020-01776-w

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