Feasibility of Echocardiographic Techniques to Detect Subclinical Cancer Therapeutics–Related Cardiac Dysfunction among High-Dose Patients When Compared with Cardiac Magnetic Resonance Imaging

Background: Cardiac magnetic resonance imaging (CMR) is the gold standard for the quantification of global and regional myocardial function and can detect subclinical myocardial dysfunction in anthracycline-induced cardiomyopathy. The aim of this study was to ascertain reliable echocardiographic parameters that can be used for the early identification of cancer therapeutics–related cardiac dysfunction, compared with CMR. Methods: Fifty-seven pediatric cancer survivors, 10 to 42 years of age, with cumulative anthracycline doses $ 200 mg/m 2 , were studied with transthoracic echocardiography and CMR 2.4 to 26.9 years after chemotherapy. Results: Three-dimensional echocardiography had the highest sensitivity in identifying subjects with CMRderived ejection fractions 29 mL/m 2 were more likely to have CMR-derived ejection fractions 29 mL/m 2 , three-dimensional speckle-tracking echocardiographic peak global longitudinal strain magnitude < � 17.5%, and a decrease in early atrial myocardial velocity at the interventricular septum of <10 cm/sec by Doppler tissue imaging are the most sensitive transthoracic echocardiographic parameters toidentifysubjectswithsubclinicalmyocardialdysfunctionbyCMR.(JAmSocEchocardiogr2016;29:119-31.)