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Background <p>Anthracycline-based chemotherapy is highly effective in breast cancer treatment but is limited by dose-dependent cardiotoxicity. Early identification of subclinical myocardial injury is crucial to prevent progression to irreversible dysfunction.</p> Objectives <p>To evaluate whether a multimodal surveillance strategy integrating left ventricular global longitudinal strain (LVGLS), left atrial reservoir strain (LASr), and high-sensitivity troponin I (hs-TnI) can predict early anthracycline-induced cardiotoxicity.</p> Methods <p>This retrospective cohort study included 50 female breast cancer patients (mean age 49.3 ± 8.5&#xa0;years) treated between January 2022 and December 2024. Echocardiography and biomarkers were assessed at baseline and 1&#xa0;month after chemotherapy. Cardiotoxicity was defined as a &gt; 10% reduction in LVEF to &lt; 53%.</p> Results <p>Cardiotoxicity occurred in 15 patients (30%). LVGLS, LASr, and hs-TnI significantly changed (all P &lt; 0.001). Independent predictors were LVGLS (aOR 1.33), LASr (aOR 0.77), and hs-TnI (aOR 1.07). hs-TnI showed the highest discriminative ability (AUC 0.940).</p> Conclusions <p>LVGLS, LASr, and hs-TnI provide complementary information for early detection of cardiotoxicity.</p> Graphical Abstract <p></p>

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A multimodal approach to early detection of anthracycline-induced cardiotoxicity: complementary roles of left ventricular global longitudinal strain, left atrial reservoir strain, and high-sensitivity troponin I

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月13日

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  • Ahmet Ferhat Kaya,
  • Mehmet Özbek

摘要

Background

Anthracycline-based chemotherapy is highly effective in breast cancer treatment but is limited by dose-dependent cardiotoxicity. Early identification of subclinical myocardial injury is crucial to prevent progression to irreversible dysfunction.

Objectives

To evaluate whether a multimodal surveillance strategy integrating left ventricular global longitudinal strain (LVGLS), left atrial reservoir strain (LASr), and high-sensitivity troponin I (hs-TnI) can predict early anthracycline-induced cardiotoxicity.

Methods

This retrospective cohort study included 50 female breast cancer patients (mean age 49.3 ± 8.5 years) treated between January 2022 and December 2024. Echocardiography and biomarkers were assessed at baseline and 1 month after chemotherapy. Cardiotoxicity was defined as a > 10% reduction in LVEF to < 53%.

Results

Cardiotoxicity occurred in 15 patients (30%). LVGLS, LASr, and hs-TnI significantly changed (all P < 0.001). Independent predictors were LVGLS (aOR 1.33), LASr (aOR 0.77), and hs-TnI (aOR 1.07). hs-TnI showed the highest discriminative ability (AUC 0.940).

Conclusions

LVGLS, LASr, and hs-TnI provide complementary information for early detection of cardiotoxicity.

Graphical Abstract