Myocardial work comes to rescue when afterload-dependency of strain cause false positives

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main source(s): The Norwegian Health Association Introduction Global longitudinal strain (GLS) can detect subclinical left ventricular (LV) dysfunction. GLS measurement is therefore recommended when chemotherapy-induced cardiotoxicity be suspected. A relative, percentage reduction in ?8% may indicate LV dysfunction induced by chemotherapy. Due to afterload-dependency, moderate increase blood pressure has the potential cause reductions beyond this threshold. However, myocardial work incorporates afterload, and used omit false positive outcomes. Purpose To investigate if increases afterload clinically relevant changes strain, more robust such changes. Methods Twenty cancer patients (41 ± 14 years) undergoing chemotherapy twenty healthy controls (49 11 years, NS) were included. All participants free from concomitant heart disease. was measured speckle-tracking echocardiography. calculated pressure-strain analysis using a previously validated method estimate (LVP) non-invasively. Recordings performed before after 2 minute stress handgrip. Results At baseline, had lower (20.1 1.1 vs 22.1 2.5%, p < 0.01) global (1810 203 2051 287 mmHg·%, than controls. Stress test moderately increased systolic pressure, similar both groups (116 10 146 17 mmHg patients, 118 12 147 21 controls). This afterload-enhancement associated with decrease 20.1 18.4 1.3% 2.5 20.3 2.5% (both 0.01). Every second participant, eleven nine controls, experienced relative >8%. In contrast, during 1810 2002 281 mmHg·% 2292 398 Figure 1 shows at afterload. Conclusions Moderate caused sufficient promote over-diagnosis cardiotoxicity. distinguish true afterload-induced decline GLS. Figure.