Background:Malignant lymphoma survivors are at a heightened risk of chronic cardiotoxicity. While multiple studies have established global longitudinal strain (GLS) assessments using echocardiography as reliable indicators of acute cardiotoxicity, their efficacy in identifying chronic cardiotoxicity remains to be clarified. GLS evaluation is more time-intensive than left ventricular ejection fraction (LVEF) assessments, necessitating careful consideration of its use in everyday clinical practice. This study aimed to evaluate transthoracic echocardiogram (TTE) parameters that might indicate subclinical cardiotoxicity and explore their effectiveness in diagnosing chronic cardiotoxicity. Enhancing the diagnostic process could allow for earlier intervention before cardiac complications occur.
Methods:The analysis included 88 adult lymphoma survivors, with a median age of 40 years. Among the participants, 46 were male and 42 were female. The median age at initial cancer diagnosis was 29 years. Cardiovascular evaluations were conducted 10 years post-treatment. The primary diagnosis was Hodgkin lymphoma in 89.8% cases, and non-Hodgkin lymphoma in 10.2%. During the follow-up period, all survivors underwent TTE with speckle tracking according.
Results: Patients with lower normal LVEF (53-61%) showed a statistically significant reduction in GLS (-17.56 ± 3.2), in comparison to those with higher normal LVEF (> 61%), who had a GLS of (-19.44 ± 2.9), p- value 0.043. This suggests that GLS may provide additional diagnostic insights.
Conclusion: Integrating GLS evaluation into follow-up TTE for patients with lower normal LVEF could enhance the detection sensitivity for chronic cardiotoxicity. In theory, those with reduced GLS alongside with lower normal LVEF are potential candidates for immediate cardioprotective therapies and more rigorous follow-up.