Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity

Aim: Evaluate the role of myocardial work by echocardiography and determine its utility as an early diagnosis of cardiotoxicity. Methods: Single-center included 180 patients over 18 years old undergoing chemotherapy, the definition of cardiotoxicity for this study was to observe a left ventricular e...

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Main Authors: Denise Cortes-Pérez, Diana Romero-Zertuche, Gabriela Rodríguez-Guzmán, Itzel Calixto-Guízar, Carlos Martínez-Hernández
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-04-01
Series:Exploration of Cardiology
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Online Access:https://www.explorationpub.com/uploads/Article/A101254/101254.pdf
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author Denise Cortes-Pérez
Diana Romero-Zertuche
Gabriela Rodríguez-Guzmán
Itzel Calixto-Guízar
Carlos Martínez-Hernández
author_facet Denise Cortes-Pérez
Diana Romero-Zertuche
Gabriela Rodríguez-Guzmán
Itzel Calixto-Guízar
Carlos Martínez-Hernández
author_sort Denise Cortes-Pérez
collection DOAJ
description Aim: Evaluate the role of myocardial work by echocardiography and determine its utility as an early diagnosis of cardiotoxicity. Methods: Single-center included 180 patients over 18 years old undergoing chemotherapy, the definition of cardiotoxicity for this study was to observe a left ventricular ejection fraction (LVEF) less than 50% and, or a global longitudinal strain (GLS) less than 16%. With these parameters, we divided the population into two groups, with cardiotoxicity and without cardiotoxicity. ROC curves were performed to determine the best cut-off point for global myocardial work to define cardiotoxicity. 2 × 2 tables were made to calculate sensitivity, specificity, positive predictive value, and negative predictive value. Results: Cardiotoxicity was established by obtaining cutoff points for global myocardial work index (GWI) with values lower than 1,381.5 mmHg%, Global Constructive Work (GCW) of 1,722 mmHg%, and myocardial efficiency [Global Work Efficiency (GWE)] of 88.5%, with a sensitivity (58.8%, 65.6%, and 52.9%) and specificity (91.8%, 82.1%, and 89.6%) respectively. Conclusions: We propose the measurement of myocardial work as a diagnostic tool for cardiotoxicity, as it has good specificity and negative predictive value, serving as an early diagnostic tool for cardiotoxicity without waiting for a decrease in LVEF and without being a marker influenced by loading conditions, in patients undergoing antineoplastic treatment.
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spelling doaj-art-bffae24ea5f749b7a7b7f5c05bd873ce2025-08-20T03:27:25ZengOpen Exploration Publishing Inc.Exploration of Cardiology2994-55262025-04-01310125410.37349/ec.2025.101254Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicityDenise Cortes-Pérez0https://orcid.org/0009-0007-3031-6611Diana Romero-Zertuche1https://orcid.org/0000-0001-8622-9110Gabriela Rodríguez-Guzmán2https://orcid.org/0000-0003-3290-3653Itzel Calixto-Guízar3https://orcid.org/0009-0004-7680-2138Carlos Martínez-Hernández4https://orcid.org/0000-0002-5295-9956Departamento de Ecocardiografía, Hospital de Cardiología del Centro Médico Nacional SXXI, Mexican Institute of Social Security, Ciudad de México 06720, MéxicoDivisión de Investigación en Salud, Hospital de Cardiología del Centro Médico Nacional SXXI, Mexican Institute of Social Security, Ciudad de México 06720, MéxicoDepartamento de Ecocardiografía, Hospital de Cardiología del Centro Médico Nacional SXXI, Mexican Institute of Social Security, Ciudad de México 06720, MéxicoDepartamento de Ecocardiografía, Hospital de Cardiología del Centro Médico Nacional SXXI, Mexican Institute of Social Security, Ciudad de México 06720, MéxicoDepartamento de Ecocardiografía, Hospital de Cardiología del Centro Médico Nacional SXXI, Mexican Institute of Social Security, Ciudad de México 06720, MéxicoAim: Evaluate the role of myocardial work by echocardiography and determine its utility as an early diagnosis of cardiotoxicity. Methods: Single-center included 180 patients over 18 years old undergoing chemotherapy, the definition of cardiotoxicity for this study was to observe a left ventricular ejection fraction (LVEF) less than 50% and, or a global longitudinal strain (GLS) less than 16%. With these parameters, we divided the population into two groups, with cardiotoxicity and without cardiotoxicity. ROC curves were performed to determine the best cut-off point for global myocardial work to define cardiotoxicity. 2 × 2 tables were made to calculate sensitivity, specificity, positive predictive value, and negative predictive value. Results: Cardiotoxicity was established by obtaining cutoff points for global myocardial work index (GWI) with values lower than 1,381.5 mmHg%, Global Constructive Work (GCW) of 1,722 mmHg%, and myocardial efficiency [Global Work Efficiency (GWE)] of 88.5%, with a sensitivity (58.8%, 65.6%, and 52.9%) and specificity (91.8%, 82.1%, and 89.6%) respectively. Conclusions: We propose the measurement of myocardial work as a diagnostic tool for cardiotoxicity, as it has good specificity and negative predictive value, serving as an early diagnostic tool for cardiotoxicity without waiting for a decrease in LVEF and without being a marker influenced by loading conditions, in patients undergoing antineoplastic treatment.https://www.explorationpub.com/uploads/Article/A101254/101254.pdfglobal myocardial work index (gwi)cardiotoxicitycancer
spellingShingle Denise Cortes-Pérez
Diana Romero-Zertuche
Gabriela Rodríguez-Guzmán
Itzel Calixto-Guízar
Carlos Martínez-Hernández
Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
Exploration of Cardiology
global myocardial work index (gwi)
cardiotoxicity
cancer
title Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
title_full Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
title_fullStr Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
title_full_unstemmed Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
title_short Utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
title_sort utility of myocardial work by echocardiography in the early diagnosis of cardiotoxicity
topic global myocardial work index (gwi)
cardiotoxicity
cancer
url https://www.explorationpub.com/uploads/Article/A101254/101254.pdf
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