Assessment Of Myocardial Damage In Breast Cancer Patients With Different Chemotherapy Regimens By Ultrasound Myocardial Work-up Technique

Objective:Myocardial work(MW)technique was used to evaluate the myocardial damage in the left ventricle(LV)of breast cancer(BC)patients with different anthracycline-containing chemotherapy regimens,to compare the effect of each chemotherapy regimen on LV myocardial damage in BC patients,and to supply a foundation for the clinical choice of treatments.Information and methods:From June 2022 to December 2022 at the Second Affiliated Hospital of Nanchang University,sixty-nine breast cancer patients were chosen and all were given a combination chemotherapy treatment.Subsequently,these BC patients were divided into 2 groups based on the chemotherapy regimens,AC chemotherapy regimen epirubicin(EPI)100 mg/m~2+cyclophosphamide(CTX)600 mg/m~2for one cycle of 21 d for a total of 4 cycles of intervention],TAC chemotherapy regimen[docetaxel(DTX)75 mg/m~2,doxorubicin(ADM)50 mg/m~2,CTX 500 mg/m~2for one cycle of 21 d for a total of 6 cycles],respectively.Thirty healthy females were used as the normal group,and all study subjects received assessment of cardiac structure and function before chemotherapy(T0),after 2 cycles of treatment(T1),and after 4cycles(T2),such as electrocardiogram,laboratory tests,and transthoracic echocardiogram,etc.Routine echocardiographic parameters,myocardial work parameters and their trends before and after treatment were described,and the effects of each chemotherapy regimen on myocardial damage and the differences in the effects of different chemotherapy regimens on myocardial damage were investigated.Results:1.there were no statistically significant differences in intra-group and inter-group comparisons of HR,2D-LVEF,LVIDd,LVIDs,LA and LVMI among subjects in the 3 groups before and after chemotherapy(P>0.05).there were no statistically significant differences in 3D-LVEF levels among subjects in the 3 groups at T0 and T1(P>0.05);while 3D-LVEF compared to T0 vs.TAC group at T2 was significantly lower(P<0.05),and the level of 3D-LVEF in the TAC group at T2 was<that in the AC and normal groups(P<0.05).2.The comparison between groups after chemotherapy revealed that at T0,no statistically significant differences were found in the overall longitudinal strain(GLS),overall work efficiency(GWE),overall ineffective work(GWW),overall work index(GWI)and overall effective work(GCW)comparing the three groups of subjects(all P>0.05);at T1 and T2,the GLS,GWI,GCW and GWE index levels in the TAC group At T1 and T2,the levels of GLS,GWI,GCW and GWE indexes in the TAC group were<AC group<normal group(P<0.05);the levels of GW indexes in the TAC group>AC group>normal group(P<0.05).3.Intra-group comparison revealed that in GLS,GWI,GCW and GWE parameters,there was T2<T1<T0 in both TAC and AC groups(P<0.05);in GWW parameters,there was T2>T1>T0 in both TAC and AC groups(P<0.05).Conclusion:1.Both TAC chemotherapy regimens and AC chemotherapy regimens can cause myocardial injury,and TAC chemotherapy regimens are more significant than AC chemotherapy regimens.2.The TAC and AC groups showed an increasing trend of myocardial damage during the observation period as the duration of chemotherapy was prolonged.