Prognostic Value of Left Ventricular Global Longitudinal Strain on
Speckle Echocardiography for Predicting Chemotherapy-Induced
Cardiotoxicity in Breast Cancer Patients: A Systematic Review and
Meta-Analysis
Abstract
Background: Literature suggests that left ventricular global
longitudinal strain (LV-GLS) on speckle echocardiography has the
potential to predict cardiotoxicity amongst breast cancer patients
receiving chemotherapy such as anthracycline, taxane, cyclophosphamide,
and trastuzumab. Our study aimed to collect evidence for the prognostic
value of LV-GLS for predicting chemotherapy-induced cardiotoxicity in
breast cancer patients. Methods: A detailed search of the
PubMed, Google Scholar, Cochrane Library, and Scopus databases was
conducted for published articles up to August 31, 2022. In our
meta-analysis, we looked at 13 studies with a total of 1007 breast
cancer patients getting chemotherapy that looked at the predictive value
of GLS. Results: Absolute GLS change during treatment showed a
pooled sensitivity of 84% (95% CI: 74% to 91%) and a pooled
specificity of 77% (95% CI: 68% to 84%). For a relative change in
GLS, we observed a pooled sensitivity of 76% (95% CI: 56% to 89%)
and a pooled specificity of 83% (95% CI: 73% to 90%). For an
absolute change in GLS, we observed a positive likelihood ratio (LR),
and the negative LR was 4 and 0.21. SROC with prediction and confidence
intervals represents a promising summary area under the curve (sAUC) of
0.88, 95% CI ranges from 0.85 to 0.91 for absolute change in GLS, as
well as for relative change (sAUC, 0.87, 95% CI 0.84 to 0.90).
Conclusion: Our results demonstrated an estimation of LV-GLS
after the beginning of required chemotherapy, including anthracyclines
and trastuzumab, had a promising prognostic value for predicting the
likelihood of CTRCD. To confirm our findings, well-designed prospective
adequately powered diagnostic randomised trials are necessary.