Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography
BackgroundEarly detection of subclinical cardiotoxicity of immune checkpoint inhibitor (ICI) therapy can be challenging.ObjectiveTo evaluate subclinical cardiac dysfunction using two-dimensional speckle tracking imaging (2D-STI) and three-dimensional echocardiography in Chinese patients.MethodsFifty...
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1087287/full |
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| author | Aiqing Xu Aiqing Xu Ming Yuan Xiaoping Zhan Gangjian Zhao Guanyu Mu Tingting Wang Hailong Hu Huaying Fu |
| author_facet | Aiqing Xu Aiqing Xu Ming Yuan Xiaoping Zhan Gangjian Zhao Guanyu Mu Tingting Wang Hailong Hu Huaying Fu |
| author_sort | Aiqing Xu |
| collection | DOAJ |
| description | BackgroundEarly detection of subclinical cardiotoxicity of immune checkpoint inhibitor (ICI) therapy can be challenging.ObjectiveTo evaluate subclinical cardiac dysfunction using two-dimensional speckle tracking imaging (2D-STI) and three-dimensional echocardiography in Chinese patients.MethodsFifty-five consecutive patients with malignant tumors treated by immunotherapy were included. They were examined by echocardiography before immunotherapy and after immunotherapy. Left ventricular ejection fraction (LVEF) was calculated in three-dimensional imaging. Moreover, left ventricular global longitudinal peak systolic strain (LVGLS), left ventricular global circumferential peak systolic strain (LVGCS), right ventricular global longitudinal systolic strain (RVGLS), right ventricular free wall longitudinal peak systolic strain (RVFWLS), and tricuspid annular plane systolic excursion (TAPSE) were evaluated. Clinical and laboratory parameters were recorded. Cardiac toxicity events were defined as the presence of heart failure symptoms, LVEF reduction, and increase in troponin. Subclinical cardiac toxicity was defined as cardiac dysfunction associated with ICI treatment, with absent or delayed ICI-associated cardiotoxicity clinical symptoms.ResultsCompared with baseline, the LVGLS, TAPSE, and RVGLS significantly deteriorated after ICI treatment [(–18.63 ± 2.53)% vs. (–17.35 ± 2.58)%, P = 0.000; 18.29 ± 6.23 vs. 14.57 ± 3.81, P = 0.0001; and (–18.45 ± 4.65)% vs. (–14.98 ± 3.85)%, P = 0.0001, respectively]. LVGLS (–17.35 ± 2.58, P = 0.000), TAPSE (14.57 ± 3.81, P = 0.0001), and RVGLS [(–14.98 ± 3.85)%, P = 0.0001] were decreased after ICI immunotherapy. Kaplan-Meier curve analysis showed that LVGLS was more sensitive than the cardiac toxicity events to assess ICI-related subclinical cardiac dysfunction (log-rank P = 0.205). The ROC curve showed that the cutoff value of ΔLVGLS was -13%.ConclusionSubclinical cardiac dysfunction can be detected using two-dimensional speckle-tracking imaging. LVGLS, RVGLS, and TAPSE are more sensitive indices for detection.Clinical trial registration[https://www.chictr.org.cn/showprojen.aspx?proj=27498], identifier [ChiCTR1800016216]. |
| first_indexed | 2024-04-13T04:01:40Z |
| format | Article |
| id | doaj.art-fa50571ed48f4084a2f9e817d44bf386 |
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| language | English |
| last_indexed | 2024-04-13T04:01:40Z |
| publishDate | 2022-12-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-fa50571ed48f4084a2f9e817d44bf3862022-12-22T03:03:28ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10872871087287Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiographyAiqing Xu0Aiqing Xu1Ming Yuan2Xiaoping Zhan3Gangjian Zhao4Guanyu Mu5Tingting Wang6Hailong Hu7Huaying Fu8Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Cardiology, Tianjin Medical University General Hospital, Tianjin, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Urology, Second Hospital of Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Urology, Second Hospital of Tianjin Medical University, Tianjin, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaBackgroundEarly detection of subclinical cardiotoxicity of immune checkpoint inhibitor (ICI) therapy can be challenging.ObjectiveTo evaluate subclinical cardiac dysfunction using two-dimensional speckle tracking imaging (2D-STI) and three-dimensional echocardiography in Chinese patients.MethodsFifty-five consecutive patients with malignant tumors treated by immunotherapy were included. They were examined by echocardiography before immunotherapy and after immunotherapy. Left ventricular ejection fraction (LVEF) was calculated in three-dimensional imaging. Moreover, left ventricular global longitudinal peak systolic strain (LVGLS), left ventricular global circumferential peak systolic strain (LVGCS), right ventricular global longitudinal systolic strain (RVGLS), right ventricular free wall longitudinal peak systolic strain (RVFWLS), and tricuspid annular plane systolic excursion (TAPSE) were evaluated. Clinical and laboratory parameters were recorded. Cardiac toxicity events were defined as the presence of heart failure symptoms, LVEF reduction, and increase in troponin. Subclinical cardiac toxicity was defined as cardiac dysfunction associated with ICI treatment, with absent or delayed ICI-associated cardiotoxicity clinical symptoms.ResultsCompared with baseline, the LVGLS, TAPSE, and RVGLS significantly deteriorated after ICI treatment [(–18.63 ± 2.53)% vs. (–17.35 ± 2.58)%, P = 0.000; 18.29 ± 6.23 vs. 14.57 ± 3.81, P = 0.0001; and (–18.45 ± 4.65)% vs. (–14.98 ± 3.85)%, P = 0.0001, respectively]. LVGLS (–17.35 ± 2.58, P = 0.000), TAPSE (14.57 ± 3.81, P = 0.0001), and RVGLS [(–14.98 ± 3.85)%, P = 0.0001] were decreased after ICI immunotherapy. Kaplan-Meier curve analysis showed that LVGLS was more sensitive than the cardiac toxicity events to assess ICI-related subclinical cardiac dysfunction (log-rank P = 0.205). The ROC curve showed that the cutoff value of ΔLVGLS was -13%.ConclusionSubclinical cardiac dysfunction can be detected using two-dimensional speckle-tracking imaging. LVGLS, RVGLS, and TAPSE are more sensitive indices for detection.Clinical trial registration[https://www.chictr.org.cn/showprojen.aspx?proj=27498], identifier [ChiCTR1800016216].https://www.frontiersin.org/articles/10.3389/fcvm.2022.1087287/fullsubclinical cardiotoxicityechocardiographystrainTAPSEICIs |
| spellingShingle | Aiqing Xu Aiqing Xu Ming Yuan Xiaoping Zhan Gangjian Zhao Guanyu Mu Tingting Wang Hailong Hu Huaying Fu Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography Frontiers in Cardiovascular Medicine subclinical cardiotoxicity echocardiography strain TAPSE ICIs |
| title | Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography |
| title_full | Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography |
| title_fullStr | Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography |
| title_full_unstemmed | Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography |
| title_short | Early detection of immune checkpoint inhibitor-related subclinical cardiotoxicity: A pilot study by using speckle tracking imaging and three-dimensional echocardiography |
| title_sort | early detection of immune checkpoint inhibitor related subclinical cardiotoxicity a pilot study by using speckle tracking imaging and three dimensional echocardiography |
| topic | subclinical cardiotoxicity echocardiography strain TAPSE ICIs |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1087287/full |
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