The Global Relationship of Longitudinal Strain and Road Test 6 Minutes Before and After Chemotherapy of Anthracycline in Breast Cancer Patients in Adam Malik Hajj Hospital in Medan
Introduction
Breast cancer is one of the most common types of cancer affecting women worldwide, with a significant number of patients experiencing heart failure as a result of chemotherapy. The global longitudinal strain (GLS) has been identified as a potential predictor of left ventricular dysfunction in patients undergoing anthracycline chemotherapy. Meanwhile, the 6-minute road test (UJ6M) has been widely used as a means of evaluating functional capacity in cancer patients. This study aims to explore the relationship between GLS measurement and UJ6M in breast cancer patients undergoing anthracycline chemotherapy.
Background
Patients with breast cancer who experience heart failure have a high mortality rate, reaching 60% within two years. Research has shown that GLS can function as an initial predictor of left ventricular dysfunction in patients undergoing anthracycline chemotherapy. The UJ6M has been increasingly used in cancer research as a means of evaluating functional capacity, with the distance traveled during the test being a prognostic factor for survival rates, especially in lung cancer patients. However, the relationship between GLS measurement and UJ6M in breast cancer patients undergoing anthracycline chemotherapy remains unclear.
Methodology
This prospective study was conducted at Adam Malik Hajj Hospital in Medan from April to November 2017. All research subjects who met the inclusion and exclusion criteria underwent initial echocardiography to assess GLS and UJ6M to assess their functional capacity. After three chemotherapy cycles, echocardiographic evaluation was carried out, and after six anthracycline chemotherapy cycles, a re-examination was carried out to assess GLS and UJ6M. The analysis was carried out to evaluate the correlation between the GLS value and the decrease in the distance traveled in the UJ6M.
Results
The results showed a significant difference in the percentage of decline in GLS value after undergoing three and six chemotherapy cycles (10.49 ± 4.94 vs 20,717 ± 9,616, p = 0.001). There was a relationship between GLS value and decrease in UJ6M value after six chemotherapy cycles, although the relationship was classified as very weak (R² = -0.084). However, the relationship between the percentage of decreased GLS and UJ6M showed P = 0.028 with R² = -0.112.
Conclusion
This study found a weak correlation between the percentage of decreased GLS and UJ6M in breast cancer patients undergoing anthracycline chemotherapy for six cycles with R² = -0.112. This suggests that although there are changes in left ventricular function detected through GLS, the impact on the patient's functional capacity as measured by UJ6M is not significant.
Additional Analysis and Explanation
The weak correlation between GLS and UJ6M may be caused by several factors, including individual variations in response to chemotherapy. Each patient has a different level of vulnerability to the side effects of chemotherapy, including the impact on the heart and physical capacity. In addition, the use of anthracycline, although effective for cancer treatment, also has the potential to cause toxicity that affects heart function.
Implications and Future Directions
This study highlights the importance of clinicians carrying out tighter monitoring of heart function and functional capacity of breast cancer patients, especially those undergoing anthracycline chemotherapy. With a better understanding of this relationship, it is hoped that a better management strategy can be developed to improve the quality of life of patients and reduce the risk of complications related to heart failure. This study also provides a basis for further in-depth research about the relationship between heart health and functional capacity in breast cancer patients, which can have an impact on the development of more effective and safe therapy protocols.
Limitations and Future Research Directions
This study has several limitations, including the small sample size and the use of a single hospital as the study site. Future studies should aim to recruit a larger sample size and include multiple hospitals to increase the generalizability of the findings. Additionally, further research is needed to explore the relationship between GLS and UJ6M in breast cancer patients undergoing different types of chemotherapy.
Conclusion
In conclusion, this study found a weak correlation between the percentage of decreased GLS and UJ6M in breast cancer patients undergoing anthracycline chemotherapy for six cycles. This suggests that although there are changes in left ventricular function detected through GLS, the impact on the patient's functional capacity as measured by UJ6M is not significant. Further research is needed to explore the relationship between heart health and functional capacity in breast cancer patients, which can have an impact on the development of more effective and safe therapy protocols.Q&A: The Global Relationship of Longitudinal Strain and Road Test 6 Minutes Before and After Chemotherapy of Anthracycline in Breast Cancer Patients in Adam Malik Hajj Hospital in Medan
Q: What is the purpose of this study?
A: The purpose of this study is to explore the relationship between global longitudinal strain (GLS) measurement and 6-minute road test (UJ6M) in breast cancer patients undergoing anthracycline chemotherapy.
Q: What is GLS and why is it important?
A: GLS is a measure of left ventricular function that can detect subtle changes in the heart's function. It is an important predictor of left ventricular dysfunction in patients undergoing anthracycline chemotherapy.
Q: What is UJ6M and why is it used in this study?
A: UJ6M is a test that measures a patient's functional capacity by assessing how far they can walk in 6 minutes. It is used in this study to evaluate the impact of anthracycline chemotherapy on a patient's physical capacity.
Q: What were the results of this study?
A: The results of this study showed a significant difference in the percentage of decline in GLS value after undergoing three and six chemotherapy cycles. There was also a relationship between GLS value and decrease in UJ6M value after six chemotherapy cycles, although the relationship was classified as very weak.
Q: What are the implications of this study?
A: The implications of this study are that clinicians should carry out tighter monitoring of heart function and functional capacity of breast cancer patients, especially those undergoing anthracycline chemotherapy. With a better understanding of this relationship, it is hoped that a better management strategy can be developed to improve the quality of life of patients and reduce the risk of complications related to heart failure.
Q: What are the limitations of this study?
A: The limitations of this study include the small sample size and the use of a single hospital as the study site. Future studies should aim to recruit a larger sample size and include multiple hospitals to increase the generalizability of the findings.
Q: What are the future directions of this research?
A: Future studies should aim to explore the relationship between GLS and UJ6M in breast cancer patients undergoing different types of chemotherapy. Additionally, further research is needed to understand the underlying mechanisms of the relationship between heart health and functional capacity in breast cancer patients.
Q: What are the potential benefits of this research?
A: The potential benefits of this research include the development of more effective and safe therapy protocols for breast cancer patients. By understanding the relationship between heart health and functional capacity, clinicians can develop better management strategies to improve the quality of life of patients and reduce the risk of complications related to heart failure.
Q: What are the potential applications of this research?
A: The potential applications of this research include the development of personalized treatment plans for breast cancer patients. By taking into account the individual patient's heart function and functional capacity, clinicians can develop more effective and safe treatment plans that meet the patient's specific needs.
Q: What are the potential risks of this research?
A: The potential risks of this research include the potential for patients to experience adverse effects from anthracycline chemotherapy. However, by understanding the relationship between heart health and functional capacity, clinicians can develop better management strategies to minimize the risk of adverse effects and improve patient outcomes.