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BioMed Research International
Volume 2016 (2016), Article ID 9363951, 8 pages
Research Article

Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer

1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
2Weill Cornell Medical Center, New York, NY 10065, USA
3Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA

Received 15 October 2015; Accepted 11 January 2016

Academic Editor: Giovanni Di Salvo

Copyright © 2016 Anthony F. Yu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Two-dimensional speckle tracking echocardiography (2DSTE) provides a sensitive measure of left ventricular (LV) systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: years; 55% male; mean time since diagnosis: years) previously treated with anthracyclines (mean cumulative dose:  mg/m2), with () or without () mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF) < 55%, and global longitudinal strain (GLS) ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18%) patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, ) and prevalence of abnormal GLS was higher (36.5% versus 14.6%, ) in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS () after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors.