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Applying global longitudinal strain in assessing cardiac dysfunction after radiotherapy among breast cancer patients: a systemic review and meta-analysis

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Abstract

Purpose

Radiation-induced heart disease (RIHD) has cost severe health burden to breast cancer patients. However, early thoracic radiotherapy (RT)-induced cardiac damage was hard to detect through traditional echocardiography. Therefore, we conducted this systemic review and meta-analysis to evaluate the changes of GLS, an innovative echocardiographic measurement, after thoracic radiotherapy.

Methods

We searched PubMed, Embase and Web of Science using the key words “breast cancer”, “radiotherapy” and “GLS” for relevant papers. Studies covered the difference of GLS change before and after radiotherapy were included, and the standard mean difference (SMD) and its standard error were extracted and pooled using a random-effects or fixed-effects model.

Results

A total of 11 studies comprising 18 comparisons were identified, and 1808 patients were involved. The pooled SMD of GLS before and within 6-week after radiotherapy was 0.48 (95% CI 0.34–0.61, p < 0.01), and the pooled long-term changes in GLS (over 6-month after radiotherapy) was 0.46 (95% CI 0.20–0.72, p < 0.01). No obvious publication bias were observed.

Conclusion

Breast cancer patients are facing greater risk of RIHD since they presented a better survival rate and longer life expectancy with the popularization of radiotherapy. GLS might be useful in capturing minimal cardiac changes shortly after radiotherapy or during long-term follow up visit.

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Funding

This research is supported by the National Science Foundation of China, Grant No. 81970341, and the National Science Foundation of China, Grant No.81773366.

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Authors and Affiliations

  1. Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China

    Bo Guan & Shijun Li

  2. School of Life Science, Anhui Medical University, Hefei, China

    Hao Luan & Zuyin Yu

  3. Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Xintao Li

  4. College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

    Tianhua Wang

  5. Department of Experimental Hematology and Biochemistry, Beijing Key Laboratory for Radiobiology, Beijing Institute of Radiation Medicine, Beijing, China

    Hao Luan & Zuyin Yu

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  1. Bo Guan
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  4. Tianhua Wang
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  5. Shijun Li
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Contributions

GB conceived and designed the study. LH reviewed the indexes and extracted data. LXT performed risk of bias assessment and analyzed the data. WTH wrote the article. LSJ and YZY supervised the data synthesis, results interpretations and oversaw the entire project.

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Correspondence to Shijun Li or Zuyin Yu.

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Guan, B., Luan, H., Li, X. et al. Applying global longitudinal strain in assessing cardiac dysfunction after radiotherapy among breast cancer patients: a systemic review and meta-analysis. Clin Transl Imaging 10, 413–424 (2022). https://doi.org/10.1007/s40336-022-00493-w

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