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Association between Left Ventricular Global Longitudinal Strain and Six Minute Walk Test Before and After Chemotherapy with Anthracycline in Breast Cancer Patients

Author : T.W. Siagian, K.Kaban ,A.P. Ketaren, K.B Siregar, H.Hasan, A.A. Siregar, A.Sitepu
Upload Date : 19-04-2018

Background: Anthracycline-induced cardiotoxicity is associated with a poor prognosis. Breast cancer patients who fall in heart failure have a mortality rate of 60% within 2 years .We can use Global longitudinal strain (GLS) to detect subclinical left ventricular (LV) dysfunction in chemotherapy patient. The distance of 6-minute walk test (6MWT) has been used as a prognostic factor in cancer patients has a relationship with other health aspects of breast cancer. This study aimed to prove whether there is a correlation between LV dysfunction before there are clinical signs of heart failure and decreased functional capacity of 6MWT in breast cancer patients.

Methods: This is a cohort prospective study of  35 breast cancer patients who have chemotherapy with anthracycline regimen.The patients were evaluated before the initiation of anthracycline therapy, after 3 and 6 cycles. Patients underwent echocardiography and 6MWT at the first visit. After 3 and 6 cycle patient underwent echocardiography and 6MWT after 6 cycle. Association between GLS, cardiac parameter and functional capacity was assessed using Pearson's correlation for continuous normally distributed variables and Spearman's correlation for categorical and non-normally distributed variables. p value < 0.05 was considered to indicate statistical significance.

Results: The mean age was 45.83 ± 6.96 years. There was a significant difference in percentage reduction of GLS after chemotherapy 3 cycles and 6 cycles (10.49 ± 4.94 vs. 20.717 ± 9.616, p = 0.001). GLS is correlated with a decrease in total distance 6MWT after 6 cycles (R2 = -0.084) and the correlation of  percentage reduction of  GLS and distance of 6MWT has p = 0.028 and R2 = -0.112

Conclusion: There is a correlation between the percentage reduction of GLS and distance of 6MWT  in breast cancer patients with anthracycline chemotherapy for 6 cycles (R2 = -0.112)

KEYWORDS : GLS, 6MWT, anthracycline, chemotherapy, breast cancer.

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