SỰ TƯƠNG THÍCH GIỮA PHÂN SUẤT TỐNG MÁU THẤT TRÁI VÀ SỨC CĂNG TRỤC DỌC THẤT TRÁI TRONG CHẨN ĐOÁN SỚM RỐI LOẠN CHỨC NĂNG TIM Ở BỆNH NHÂN UNG THƯ HOÁ TRỊ BẰNG DOXORUBICIN: NGHIÊN CỨU HAI TRUNG TÂM

Abstract

Background: Chemotherapy has significantly improved cancer prognosis over the past decades; however, it has also increased the incidence of serious cardiovascular complications, especially Doxorubicin. Echocardiographic assessment of left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV-GLS) has become a cornerstone imaging modality before, during, and after Doxorubicin-based chemotherapy. Objectives: To evaluate the compatibility between early diagnosis of cardiac dysfunction using left ventricular ejection fraction and left ventricular global longitudinal strain in cancer patients undergoing Doxorubicin chemotherapy. Materials and methods: This was a cross-sectional descriptive study conducted on 63 cancer patients undergoing Doxorubicin-based chemotherapy at the University of Medicine and Pharmacy Hospital, Can Tho University of Medicine and Pharmacy, and Can Tho Oncology Hospital from March 2023 to May 2024. Results: A total of 63 patients undergoing Doxorubicin-based chemotherapy were enrolled, with a mean age of 54.49 ± 10.12 years, and the majority were female (87.7%), with breast cancer accounting for 77.8%. The cumulative dose of Doxorubicin after one month was 8257.85 ± 38.27 mg/m². After one month of chemotherapy, 41.3% of patients developed cardiac dysfunction. Left ventricular global longitudinal strain significantly decreased after one month of treatment (from −18.47 ± 2.88% to −15.83 ± 3.8%, p < 0.001), while left ventricular ejection fraction remained unchanged (p = 0.853). The proportion of patients with cardiac dysfunction according to a relative decrease in LV-GLS >15% was the highest (36.5%), compared to 17.5% based on a decrease in LVEF >10%, and only 3.2% with LVEF <50%. There was a weak agreement between the diagnostic criteria based on LV-GLS and LVEF on echocardiography (Kappa = 0.307; p = 0.008). Conclusion: In cancer patients undergoing Doxorubicin-based chemotherapy, echocardiographic assessment of left ventricular global longitudinal strain enabled earlier detection of subclinical cardiac dysfunction compared to conventional left ventricular ejection fraction evaluation.