Feasibility and reproducibility of different echocardiographic indices of left ventricular function for long-term follow-up to detect cardiotoxocoty after breast cancer therapy

Abstract

Background. Cancer therapy may be cardiotoxic. There is a need for reproducible methods for longitudinal follow-up of cardiac function in these patients before, during and after cancer treatment. Purpose. The aim was to evaluate the feasibility and reproducibility of echocardiographic indices recommended for follow-up evaluation of left ventricular function in breast cancer patients. Material and methods. Echocardiographic recordings from 55 former breast cancer patients at their follow-up visit 7 years post treatment were analysed using 14 indices and investigated with respect to feasibility and reproducibility. The data obtained was analysed twice by the same operator for intra-rater reproducibility and by two separate operators for inter-rater reproducibility investigations. Results. The feasibility was excellent for Mitral Annular Plane Systolic Excursion (MAPSE) and all Doppler indices, and poor for tracking based Global Longitudinal Strain (AFI GLS). The semi-Automatic Left Ventricular Ejection Fraction (Auto EF), contrast enhanced LVEF ad. Simpson’s rule and Early diastolic trans Mitral blood Velocity (MVE Vel) had significantly better reproducibility than 4 other indices. Conclusions. Intra-rater results are better than inter-rater results. Follow-up examinations by the same operator will improve the reproducibility compared to change of operator. Relevance. The number of breast cancer survivors is increasing due to better cancer therapy. For early detection of cardiotoxicity during or after cancer therapy there is a need for feasible and reliable measurements of cardiac function indices.