We investigated the usefulness of the left atrial (LA) strain measurement on the prediction of upcoming cancer therapeutics-related cardiac dysfunction (CTRCD) after trastuzumab therapy in patients with breast cancer who did not develop CTRCD after chemotherapy. A total of 72 females with breast cancer who did not develop CTRCD after chemotherapy and underwent additional trastuzumab therapy were divided into CTRCD (n = 13) and no CTRCD group (n = 59). Echocardiographic measurements including left ventricular global longitudinal strain (LVGLS) and peak atrial longitudinal strain (PALS) decline were compared. CTRCD was identified in 13 patients (18.1%) after additional trastuzumab therapy. Baseline echocardiographic findings were not different. After the completion of chemotherapy, conventional echocardiographic parameters were not different, but PALS decline (15.0 ± 4.7 vs. 8.9 ± 3.2%, p < 0.001) and LVGLS decline (10.5 ± 1.3 vs. 9.1 ± 1.1%, p = 0.002) were significantly greater in CTRCD than in no CTRCD group. PALS decline at the time of chemotherapy completion could predict future CTRCD after trastuzumab therapy with better sensitivity and specificity (cutoff value 11.79%, sensitivity 76.9% and specificity 81.4%) than LVGLS decline (cutoff value 9.9%, sensitivity 69.2% and specificity 78.0%). PALS or LVGLS decline developed before developing overt CTRCD after chemotherapy for breast cancer, and PALS decline showed better sensitivity and specificity in predicting future CTRCD than LVGLS decline. Serial measurement of PALS can be used as a useful parameter in the prediction of future CTRCD.

中文翻译：

---

左心房纵向应变可预测乳腺癌患者与癌症治疗相关的心脏功能障碍。

我们调查了左心房（LA）应变测量对曲妥珠单抗治疗的乳腺癌患者在化疗后未发展为CTRCD的预测中与癌症治疗相关的心功能不全（CTRCD）的预测的有用性。共有72例乳腺癌女性在化疗后未发展为CTRCD，并接受了额外的曲妥珠单抗治疗，分为CTRCD（n = 13）和无CTRCD组（n = 59）。超声心动图测量包括左心室总纵向应变（LVGLS）和最大心房纵向应变（PALS）下降进行了比较。接受其他曲妥珠单抗治疗后，在13例患者（占18.1％）中发现了CTRCD。基线超声心动图检查结果无差异。化疗结束后，常规超声心动图参数没有变化，但是CTRCD组的PALS下降（15.0±4.7对8.9±3.2％，p <0.001）和LVGLS下降（10.5±1.3对9.1±1.1％，p = 0.002）明显大于无CTRCD组。曲妥珠单抗治疗后PALS下降可以预测曲妥珠单抗治疗后的未来CTRCD的敏感性和特异性（临界值11.79％，敏感性76.9％和特异性81.4％）比LVGLS下降（临界值9.9％，敏感性69.2％和特异性78.0％）更好）。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。CTRCD组的1±1.1％，p = 0.002）显着高于无CTRCD组。曲妥珠单抗治疗后PALS下降可以预测曲妥珠单抗治疗后的未来CTRCD的敏感性和特异性（临界值11.79％，敏感性76.9％和特异性81.4％）比LVGLS下降（临界值9.9％，敏感性69.2％和特异性78.0％）更好）。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。CTRCD组的1±1.1％，p = 0.002）显着高于无CTRCD组。曲妥珠单抗治疗后PALS下降可以预测曲妥珠单抗治疗后的未来CTRCD的敏感性和特异性（临界值11.79％，敏感性76.9％和特异性81.4％）比LVGLS下降（临界值9.9％，敏感性69.2％和特异性78.0％）更好）。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。曲妥珠单抗治疗后PALS下降可以预测曲妥珠单抗治疗后的未来CTRCD的敏感性和特异性（临界值11.79％，敏感性76.9％和特异性81.4％）比LVGLS下降（临界值9.9％，敏感性69.2％和特异性78.0％）更好）。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。曲妥珠单抗治疗后PALS下降可以预测曲妥珠单抗治疗后的未来CTRCD的敏感性和特异性（临界值11.79％，敏感性76.9％和特异性81.4％）比LVGLS下降（临界值9.9％，敏感性69.2％和特异性78.0％）更好）。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。PALS或LVGLS下降在乳腺癌化疗后出现显性CTRCD之前就已经形成，并且PALS下降比LVGLS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。PALS或LVGLS下降在乳腺癌化疗后出现明显的CTRCD之前就已经形成，与LVGLS下降相比，PALS下降在预测未来CTRCD方面显示出更好的敏感性和特异性。PALS的串行测量可以用作预测未来CTRCD的有用参数。