Abstract
Background Cardiac dysfunction associated with anthracyclines is a signifcant side efect of chemotherapy, and early detection is crucial. We aimed to assess the diagnostic value of combining global longitudinal strain (GLS) with biomarkers for
the early detection of anthracycline-related cardiac dysfunction.
Methods In a prospective cohort study, 80 consecutive adult patients (mean age 51±11 years; 68.8% females) were screened
and underwent 2D echocardiographic assessments and biomarker assessments [high-sensitivity troponin-I (hs-Troponin-I)
and NT-pro brain natriuretic peptide (NT-proBNP)] before and after anthracycline-based chemotherapy’s initial regimen.
The patients were followed up for 12 weeks to monitor for the development of cardiotoxicity.
Results Ten patients (12.5%) developed cardiotoxicity at the end of the 12-week follow-up. Baseline values of hs-Troponin-I
and NT-proBNP were signifcantly higher in patients who developed cardiotoxicity compared to those who did not, with
a similar pattern observed at the 3-week follow-up. Receiver operating characteristic (ROC) curve analysis demonstrated
that a cutof value of baseline hs-Troponin-I>11 ng/L, NT-proBNP>90.1 pg/mL, 3-week left ventricular ejection fraction
(LVEF)≤52%, 3-week GLS≥− 14.5%, 3-week hs-Troponin-I>13.1 ng/L, and 3-week NT-proBNP>118.1 pg/mL predicted
the occurrence of cardiotoxicity with high sensitivity (range 83–94%) and specifcity (range 77–92%).
Conclusion Combination of GLS with biomarkers had a high diagnostic value in early identifcation of anthracycline-related
cardiac dysfunction, with an estimated diagnostic accuracy of over 85%. This information could potentially help in the identifcation of patients at high risk of developing cardiac dysfunction, allowing for earlier management.