Assessment of the Prognostic Value of Left Ventricular Global Longitudinal Strain for Early Prediction of Cardiotoxicity Among Adult Cancer Patients Receiving Cardiotoxic Chemotherapy

Introduction: The evaluation of global longitudinal strain (GLS) is recognised in cardio-oncology for the early detection of cardiotoxicity associated with anticancer therapies. Baseline left ventricular (LV) global longitudinal strain (GLS) and right ventricular (RV) GLS evaluations can detect patients predisposed to systolic dysfunction and heart failure resulting from the cardiotoxic effects of many cancer therapies. Progress in the early identification and management of cancer has markedly decreased mortality rates. The outcome is the formation of a group of patients whose survival is adequate to demonstrate the side effects of the administered medicines. Cardiotoxicity refers to the array of cardiovascular disorders induced by onco-hematological therapies. Objectives: To assess the significance of global longitudinal strain in the early identification of cardiotoxicity in individuals receiving chemotherapy. Method: A quantitative, analytical, prospective, longitudinal study was carried out in 100 patients diagnosed with breast cancer or lymphoma, who started chemotherapy treatment at Department of Cardiology, S.C.B. Medical College and Hospital, Cuttack, Odisha. Primary and secondary methods were used for raw data collection and several statistical tests were used for its analysis. Results: The notable association between GLS and chemotherapy dosage underscores the necessity of monitoring cumulative exposure and the potential for early intervention with cardioprotective therapies. this investigation demonstrated a modest positive connection between GLS and LVEF (r = 0.61, p < 0.001), reinforcing the notion that these two echocardiographic parameters are interconnected, but not synonymous. A moderate negative correlation (r = -0.52, p < 0.001) identified in our investigation between cumulative chemotherapeutic dosage and global longitudinal strain (GLS) underscores a distinct dose-dependent association between cardiotoxic exposure and myocardial strain deterioration. The fall in GLS occurs prior to the loss in LVEF, establishing it as a more effective early diagnostic instrument for cardiotoxicity.