We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer. HER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab. Forty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson’s r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11–2.93; p = 0.016; explained variance 0.34). Correlations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.

中文翻译：

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二维超声心动图与心脏 MRI 应变：HER2 阳性乳腺癌患者接受曲妥珠单抗的前瞻性队列研究

我们旨在研究早期二维超声心动图 (2DE) 散斑追踪 (ST) 对 HER2 阳性乳腺癌曲妥珠单抗治疗期间左心室射血分数 (LVEF) 变化的预测价值。接受曲妥珠单抗治疗的 HER2 阳性乳腺癌患者，联合或不联合蒽环类药物，在基线和 3 个月和 6 个月（m）曲妥珠单抗后接受 2DE-ST。在基线和 6 m 处进行心脏磁共振 (CMR) 成像（使用 ST）。我们研究了同时测量的 2DE-ST 和 CMR 衍生的全局纵向应变 (GLS) 和全局径向应变 (GRS) 之间的相关性。此外，我们将基线和 3 m 2DE-ST 测量值与后来的 CMR-LVEF 和心脏毒性相关联，定义为曲妥珠单抗期间 CMR-LVEF < 45% 和/或绝对下降 > 10%。包括 47 名患者。中位基线 LVEF 为 60.4%。基于 2DE-ST 和 CMR 的 GLS 测量显示出弱相关性（Pearson 的 r = 0.33；p = 0.041）；GRS 测量结果不相关（r = 0.09；p = 0.979）。基线和 3 m 处的 2DE-LVEF 和 3 m 处的 2DE-ST-GLS 可预测 6 m 处的 CMR-LVEF。相比之下，2DE-ST-GLS 在 3 m 处的变化可预测 CMR-LVEF 在 6 m 处的变化，而 2DE-LVEF 的变化则不是。重要的是，发生心脏毒性的 11 名患者 (28%) 在 3 m 处的 2DE-ST-GLS 变化大于未发生的患者（中位数 5.2% 点对 1.7% 点；1% 差异变化的优势比为 1.81, 95 % 置信区间 1.11–2.93；p = 0.016；解释方差 0.34）。2DE-ST 和 CMR 衍生测量之间的相关性很弱。尽管如此，