Abstract 13881: The Utility of Strain Echocardiography in Follow up for Esophageal Cancer Patients Treated With Mediastinal Radiation Therapy

IntroductionMediastinal radiotherapy (RT) is a common and beneficial treatment modality in the management of esophageal cancer. Therefore, the effect of high dose RT on cardiac function in the oncologic population is ideally studied in esophageal cancer. The aim of this study was to evaluate the utility of two-dimensional speckle tracking echocardiography (2DSTE) in detecting changes in global and regional cardiac function in esophageal cancer patients who received high-dose mediastinal RT.MethodsTransthoracic echocardiograms (TTE) pre and post RT were analyzed. Post RT echocardiograms ranged between 1 week to 3 years after RT. 2DSTE was performed using TomTec software. TTEs were analyzed for changes in Simpson’s biplane left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and regional longitudinal strain. Statistical analysis was performed using a paired sample t-test, with a p-value < 0.05 considered statistically significant.ResultsBetween 2012 and 2018, 26 patients with esophageal cancer were included. Mean age at time of RT was 69 years. Patient demographics and chemotherapy regimen received are listed in Table 1. The mean heart radiation dose was 30 GY. Comparing the pre and post RT TTE, the change in biplane LVEF was not significant (56.69 ± 11.69 to 53.12 ± 12.75, p=0.176). The change in LV GLS trended towards statistical significance (-14.37 ± 4.95 to -11.89 ± 5.46, p=0.072). The change in septal longitudinal strain was statistically significant (-13.19 ± 4.68 to -10.14 ± 5.04, p=0.029).ConclusionsThese findings suggest that 2DSTE is useful in detecting changes in regional LV function in esophageal cancer patients treated with high-dose mediastinal RT, with statistically significant changes in the septal region. Long-term association with cardiac events requires further study.