In many countries, cancer is the leading cause of death in people before the age of 70, with an estimated 19.3 million new cases and 10 million deaths; advances in care have increased the number of patients living with cancer worldwide, but these patients frequently develop cardiovascular disease (CVD), including ischemic heart disease, stroke or heart failure (HF).

Cancer-therapy-related cardiovascular toxicity (CTR-CVT) refers to the various CV manifestations, which may arise during or after the use of cardiotoxic drugs or chest radiation, including cardiac dysfunction (i.e., HF or myocarditis), hypertension, vascular toxicity (coronary and peripheral artery disease, venous thrombosis), cardiac arrhythmias and pericardial and valvular heart disease. Cardio-oncology uses imaging methods that are more suitable for detecting early CTRCD, including echocardiography and global longitudinal strain (GLS).

One of the main aims of echocardiography was the evaluation of cardiac function, using estimation of LV ejection fraction (LVEF) and measurements of diastolic filling; however, these measurements only partially describe the complex LV myocardium deformation during systole, which is characterized by longitudinal and circumferential shortening and radial thickening on the long axis, while the apex rotates in an anticlockwise rotation, and the base rotates in the reverse direction.

The 2D speckle tracking echocardiography (STE) is an ultrasound technique that allows
the assessment of longitudinal, circumferential, and radial strain parameters of LV contractile function. The myocardial deformation is quantified as the percentage change in the length of a myocardial segment compared to its length at rest, using the movement of bright speckles generated by a scatter of the ultrasound beam.

Moreover, GLS was also demonstrated to be a better predictor of mortality than LVEF in aortic stenosis and HF, especially with LVEF >35%. In addition, in the general population, LV dysfunction assessed with GLS is four times more common than LV dysfunction assessed with LVEF, and it is an independent predictor of CV morbidity and mortality.

These features have made GLS a very useful technology in patients with cancer, who benefit most from an accurate cardiovascular evaluation before starting treatment to reduce the incidence of CV events, to evaluate patients during follow-up, and to better understand the role of cardioprotective therapies during cancer therapy.

The scope of this Research Topic is to better understand the role of advanced echocardiography in diagnosis, prognosis, and evaluation during the follow-up of patients who undergo cancer therapy.

This research topic is open to either original research papers or review articles in the area of the role of advanced echocardiography in cardio-oncology.

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Frontiers in Cardiovascular Medicine

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