Strain echo imaging for cancer chemotherapy toxicity

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The American Society of Echocardiography and European Association of Echocardiography are developing
guidelines to optimize the use of the echo imaging before and during cancer treatment to minimize cardiac
damage. Cancer patients are at risk for cardiovascular disease. The leading cause of death among breast cancer survivors in remission is heart disease as per Dr Juan Carlos Plana, of the Cardio-Oncology Center at the Cleveland Clinic.

Strain echo imaging allows physicians to identify the performance of each segment of the heart. In cancer
chemotherapy toxicity is not a global phenomenon, that the entire heart is not compromised. So, a global
indicator like ejection fraction could miss specific toxicity. Strain imaging, on the other hand, assesses each
segment of the heart separately, even color-coding the segments, which would give physicians a much more
accurate indication of cardiotoxicity as a result of cancer therapy.

Strain imaging also can pick up cardiac toxicity damage earlier than measuring ejection fraction can. Strain
imaging also can prognosticate a future drop in cardiac function. Strain imaging gives information three months in advance of a drop in ejection fraction.

Every patient should have a baseline echocardiogram. Cardiotoxicity starts at different times for different
cancer therapies. The guidelines are expected to be published at the end of the year.