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Prof. Maurizio Galderisi ,
The study "Strain-oriented strategy for guiding cardioprotection initiation of breast cancer patients experiencing cardiac dysfunction" by Ciro Santoro and coworkers, Federico II University Hospital of Naples, published in European Heart Journal Cardiovascular Imaging 2019, July 21, merits attention
This is the first study to demonstrate that in a population of HER 2 positive breast cancer patients undergoing cancer therapy the use of a strain-oriented approach - obtainable by speckle tracking echocardiography - may be helpful to drive the initiation of a timely cardioprotection, with clear impact on the onset of subsequent overt heart failure and on cancer therapy withdrawn. It is noteworthy that, by applying the global longitudinal strain-oriented strategy, the incidence of overt cancer therapeutics related cardiac dysfunction (3.4%) was substantially lower than that reported in other recent investigations (from 7 to 34%). Most importantly, all the patients developing subclinical cancer therapeutics related cardiac dysfunction were able to complete cancer therapy without interruption, also obtaining an almost complete recovery of both global longitudinal strain and ejection fraction thanks to cardioprotective regimen (beta-blockers + ACE inhibitors).
This study, therefore, puts a spotlight on the “strain-oriented” approach in detecting cancer therapeutics related cardiac dysfunction and its prompt treatment, a matter that both cardiologists and oncologists will have to be aware of in the future years. This strategy may effectively prevent overt and irreversible heart failure and avoid the inevitable subsequent interruption of CT, with clear negative reflections on cancer progression end relapse.
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