الفهرس 
Breast CancerOnly 14 pages are availabe for public view
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Abstract
The incidence of breast malignancy is increasing and it became evident that chemotherapy
protocols that are based on anthracyclines and trastuzumab, which are being used in these
patients, have cardiotoxic effect. (1)
Chemotherapy agents used in treatment of breast cancer are associated with unique and
varying degrees of myocardial injury, often measured as declines in left ventricular ejection
fraction (LVEF). (2)
Global longitudinal strain (GLS) has demonstrated potential for identifying early
chemotherapy related myocardial injury. (2)
Patients and Methods:
The study included 200 breast cancer female patients receiving chemotherapy and /or radiotherapy.
The patients were randomized to 2 groups, one of them received upfront therapy of ACE inhibitors in association with chemotherapy dose prescribed by the oncology department, while the other did not.
Speckle tracking echocardiography was performed as part of the echocardiographic examination for both groups, performed at 0,3, 6 ,9 ,12 months follow up after the first cycle of treatment in same week.
Also we administered ACE ( Ramipril 1.25mg ) in order to trace the effectiveness of ACE in myocardial protection of patients’ under chemotherapy or chemotherapy and radiotherapy.
RESULTS
Global longitudinal strain (GLS) has demonstrated potential for identifying early chemotherapy related myocardial injury. (112)
VI
Conclusion:
1- Global longitudinal strain is able to detect subclinical LV dysfunction earlier than LVEF
measurement in women undergoing chemotherapy or chemotherapy and radiotherapy.
2- The chemotherapy or chemotherapy and radiotherapy induced LV dysfunction is potentially
reversible with the use of ACEI that results in improved clinical outcomes
Keywords:
Global longitudinal strain (GLS), left ventricular dysfunction, ejection fraction, ACEI Speckle Tracking echocardiography, breast cancer, Chemotherapy and radiotherapy, chemotherapy related myocardial injury.