title: Torsion analysis in the early detection of anthracycline-mediated cardiomyopathy.
abstract: OBJECTIVE
  Anthracyclines have profound consequences on the structure and function of the heart, which over time cause a cardiomyopathy that leads to congestive heart failure. Early detection of subclinical left ventricular (LV) dysfunction following a low dose of anthracyclines may be a preventive strategy. The aim of this study was to determine torsion analysis using two-dimensional speckle-tracking imaging (STI), useful for detecting early anthracycline-mediated cardiotoxicity.
  
  
  RESULTS
  Conventional and Doppler echocardiography images were obtained from 25 patients (mean age 58 ± 11 years) before chemotherapy and 1 and 3 months after treatment. The cumulative anthracycline doses were 98 ± 59 and 170 ± 87 g/m(2) at 1 and 3 months, respectively. After standard echocardiography, LV torsion and twisting velocity profiles from apical and basal short-axis images were analysed using STI. LV dimensions and ejection fraction did not change throughout follow-up. Although isovolumic relaxation time showed prolongation 3 months after chemotherapy, other Doppler indices did not show significant changes. However, significant deteriorations in torsion (P < 0.0001 by ANOVA), twisting rate (P < 0.0001 by ANOVA), and untwisting rate (P < 0.001 by ANOVA) were found 1 month after chemotherapy. A significant negative correlation was observed between cumulative anthracycline doses and torsion (r = -0.524, P < 0.0001).
  
  
  CONCLUSIONS
  LV torsion analysis could be a useful non-invasive approach for early detection of subclinical anthracycline cardiotoxicity.
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Matsumoto, Japan. hmotoki@shinshu-u.ac.jp
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Motoki
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakazawa
authors.forename: Kazunori
authors.initials: K
authors.lastname: Aizawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kasai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Izawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tomita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Setsuo
authors.initials: S
authors.lastname: Kumazaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: D000704:Analysis of Variance; D018943:Anthracyclines / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000000981:diagnostic imaging*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013223:Statistics as Topic; D013997:Time Factors; D054159:Torsion, Mechanical; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D018943:Anthracyclines