To investigate the value of two-dimensional speckle tracking imaginein detecting the myocardial dysfunction of the left ventriclein patients with breast cancer during neoadjuvant chemotherapy with anthracyclines (ANT).

A total of 49 female patients who received ANT treatment (ANT group) at Shengjing Hospital of China Medical University from December 2018 to March 2020 and 25 healthy volunteers (control group) were collected. Echocardiography was performed before every episode of chemotherapy (t0-t5) and before surgery (t6) to obtain routine echocardiographic parameters. Speckle tracking software was used to analyze the general parameters, including global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), apical peak rotation (AP-Prot), mitral valvular peak rotation (MV-Prot), and left ventricular twist (LV-Tw). Parameters were compared among different timepoints and between the two groups.

There was no significant difference in left ventricular parameters between the ANT group (t0) and the control group. The general echocardiography parameters E/A, left ventricular ejection fraction (LVEF), and E/e' decreased, among which LVEF decreased significantly at t4. LVEF values were 62.4%±2.0%, 62.4%±2.0%, 62.3%±2.1%, 62.0%±2.0%, 61.6%±1.8%, 61.1%±1.7%, and 60.2%±1.8% at t0 to t6,respectively (F=13.533, P＜0.05), and the mean difference between t4 and t0 and between t4 and t3 was 0.857 and 0.548, respectively (P＜0.05 for both). The strain parameters including GLS, GCS, and GRS showed a downward trend. GLS began to decrease at t1, and it was -22.0%±1.4%, -21.8%±1.4%, -21.1%±1.4%, -20.0%±1.0%, -19.3%±1.1%, -18.7%±1.2%, and -18.1%±1.2%at t0 to t6,respectively (F=62.473, P＜0.05), and the mean difference between t1 and t0 was 0.224 (P＜0.05). The absolute value of torsion parameter MV-prot did not change significantly. The absolute values of AP-prot and LV-TW decreased at t1. AP-prot decreased most obviously （t1 vs t0: P＜0.05).

Speckle tracking imaging is of great value in monitoring the cardiotoxicity caused by low dose ANT during neoadjuvant chemotherapy. GLS and AP-Protarethe most sensitive indicators to evaluate the cardiac injury in breast cancer patients receiving low dose ANT.