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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1464368
This article is part of the Research Topic A silent Threat: Novel Treatments and Therapies to Prevent Cancer Treatment-Induced Cardiotoxicity View all 4 articles

Assessment of myocardial deformation by CMR tissue tracking reveals left ventricular subclinical myocardial dysfunction in patients with gynecologic cancer undergoing chemotherapy ☆

Provisionally accepted
Kai Tao Kai Tao 1Lu Ye Lu Ye 1Yan-Jia-Ni Xu Yan-Jia-Ni Xu 2Meng-Xi Yang Meng-Xi Yang 1Rutie YIN Rutie YIN 1Qingli Li Qingli Li 1Xiaojuan Lin Xiaojuan Lin 1Kemin LI Kemin LI 1Liang Song Liang Song 1Yu Ma Yu Ma 1Lan Zhong Lan Zhong 1Ying Hu Ying Hu 1Huayan Xu Huayan Xu 1Dan-Qing Wang Dan-Qing Wang 1Yingkun Guo Yingkun Guo 1*
  • 1 West China Second University Hospital, Sichuan University, Chengdu, China
  • 2 West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Background: Chemotherapy-induced cardiotoxicity is a concern for patients with gynecologic cancer. This study aimed to assess left ventricular (LV) myocardial deformation in patients with gynecologic cancer undergoing chemotherapy and to investigate the association between myocardial deformation and chemotherapy factors.Methods: Cardiac magnetic resonance (CMR) was performed to assess LV deformation parameters using CMR tissue tracking based on cine images. Serum myocardial injury biomarker were measured. Deformation parameters were compared between healthy controls and patients. Changes in deformation were assessed as chemotherapy progressed. Correlations between LV deformation parameters, clinical characteristics, and serum myocardial injury biomarkers were also analyzed.Results: A total of 86 patients with gynecologic cancer and 30 normal controls were included. Among the patients, 41 completed CMR follow-up with a median interval of 6 months. Compared to the controls, patients exhibited lower absolute value of global radical strain (GRS) (37.30 ± 8.94% vs. 44.32 ± 8.44%), global circumferential strain (GCS) (-22.12 ± 3.05% vs. -24.08 ± 2.13%) and global longitudinal strain (GLS) (median -15.72% [IQR-17.13 to -13.58%] vs. median-17.60% [IQR -19.05 to -15.84%]) (all p < 0.05). Patients with preserved LV ejection fraction (LVEF) also showed impaired global strain (all p < 0.05). GRS (37.30 ± 8.94% vs. 31.4 ± 12.11%), GCS (median -22.67% [IQR -24.25 to -20.03%] vs. median-19.93% [IQR -21.83 to -18.89%]), and GLS (median -15.72% [IQR -17.13 to -13.58%] vs. median -12.72% [IQR -14.73 to -10.43%]) further decreased as the number of chemotherapy cycles increased during follow-up (all p < 0.05). Multivariate analysis showed that GCS was independently associated with the number of chemotherapy regimens (Standard regression coefficient [β] = 0.397, p < 0.001).Conclusions: Myocardial deformation is more sensitive than LVEF in detecting subclinical left ventricular dysfunction in patients with gynecologic cancer undergoing chemotherapy. GCS was associated with the number of chemotherapy regimens.

    Keywords: cardiac magnetic resonance, cardiotoxicity, Tissue tracking, Left ventricular deformation, neoplasm

    Received: 13 Jul 2024; Accepted: 08 Jan 2025.

    Copyright: © 2025 Tao, Ye, Xu, Yang, YIN, Li, Lin, LI, Song, Ma, Zhong, Hu, Xu, Wang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yingkun Guo, West China Second University Hospital, Sichuan University, Chengdu, China

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