BACKGROUND Strain imaging is a robust clinical tool in cardiac surveillance of patients with breast cancer. However, image quality and therefore ability to accurately measure strain are often limited in this patient group because of tissue expanders, implants, and/or flap reconstruction. The aim of the present study was to evaluate the feasibility of measuring left ventricular longitudinal strain (LVLS) in the echocardiographic subcostal view in female patients with breast cancer. METHODS A total of 110 studies from 68 female patients with breast cancer were included. The feasibility of LVLS speckle-tracking measurements in the apical three-chamber (3C) and four-chamber (4C) views and in the subcostal 3C and 4C views was evaluated. The LVLS speckle-tracking measurements obtained in these two echocardiographic views were compared using intraclass correlation coefficients and Bland-Altman analyses. RESULTS The feasibility of LVLS in the apical 3C and 4C views was 98.1% and 98.1%, respectively. In comparison, the feasibility of LVLS in the subcostal 3C and 4C views was 93.6% and 96.3%, respectively. A high degree of reliability was found between apical and subcostal LVLS 3C and 4C measurements. For the 3C view, the average measure intraclass correlation coefficient was 0.81 (95% CI, 0.72-0.88). For the 4C view, the average measure intraclass correlation coefficient was 0.80 (95% CI, 0.70-0.87). Bland-Altman analysis showed good agreement between apical and subcostal measurements in both the 3C and 4C views. CONCLUSIONS Subcostal 3C and 4C LVLS can be reliably measured, with good agreement with conventional LVLS from the apical views, in female patients with breast cancer. Importantly, the subcostal view may provide a novel alternative for trending LVLS in patients with breast cancer who have technically limited apical windows.

中文翻译：

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乳腺癌患者的肋下基于视野的纵向应变是常规根尖基于视野的纵向应变的替代方法。

背景技术应变成像是在乳腺癌患者的心脏监视中的强大的临床工具。然而，由于组织扩张器，植入物和/或皮瓣重建，在该患者组中图像质量以及因此准确测量应变的能力通常受到限制。本研究的目的是评估在女性乳腺癌患者的超声心动图肋下视图中测量左心室纵向应变（LVLS）的可行性。方法包括来自68位女性乳腺癌患者的110项研究。评估了在心尖三腔（3C）和四腔（4C）视图以及肋下3C和4C视图中进行LVLS斑点跟踪测量的可行性。使用组内相关系数和Bland-Altman分析比较了在这两个超声心动图视图中获得的LVLS散斑跟踪测量结果。结果在根尖的3C和4C视图中LVLS的可行性分别为98.1％和98.1％。相比之下，在肋下3C和4C视野中LVLS的可行性分别为93.6％和96.3％。在心尖和肋下LVLS 3C和4C测量之间发现高度的可靠性。对于3C视图，平均度量类内相关系数为0.81（95％CI，0.72-0.88）。对于4C视图，平均度量类内相关系数为0.80（95％CI，0.70-0.87）。Bland-Altman分析显示，在3C和4C视图中，根尖测量和肋下测量均具有良好的一致性。结论可以可靠地测量肋下3C和4C LVLS，在女性乳腺癌患者中，从根尖上看与常规LVLS吻合良好。重要的是，肋下视图可能为根尖技术上受技术限制的乳腺癌患者的LVLS趋势提供了一种新颖的选择。