The predictive value of two-dimensional speckle tracking imaging technology of ultrasound for cardiotoxic reactions caused by chemotherapy in advanced gastric cancer

CHAI Lili; ZHANG Jing; LI Lifeng; CHENG Weili

doi:10.20258/j.cnki.1006-9011.2025.09.013

Abstract：Objective To explore the predictive value of ultrasound two-dimensional speckle tracking imaging(2D-STI)technology for cardiotoxic reactions caused by chemotherapy in advanced gastric cancer.Methods A total of 106 patients with advanced gastric cancer were selected and all received 6 cycles of chemotherapy with epirubicin combined with oxaliplatin and te-giol.The occurrence of cardiotoxic reactions caused by chemotherapy was statistically analyzed.Cardiac ultrasound 2D-STI ex-aminations were performed before chemotherapy and at the end of the 3rd and 6th cycles of chemotherapy respectively.The ultra-sound 2D-STI parameters of patients with advanced gastric cancer at different chemotherapy times were compared,including global longitudinal strain(GLS),subintimal longitudinal strain(GLS-endo),middle longitudinal strain(GLS-mid),subepinal longitudinal strain(GLS-epi),circumferal strain(GCS),and radial strain(GRS).The binary logistic regression model was used to analyze the independent risk factors for cardiotoxic reactions after chemotherapy in patients with advanced gastric cancer.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of ultrasound 2D-STI parameters for cardiotoxic reactions caused by chemotherapy in patients with advanced gastric cancer.Results After 3 and 6 cycles of che-motherapy,the GLS,GLS-endo,GLS-mid,GCS and GRS of patients with advanced gastric cancer were significantly lower than those before chemotherapy(all P<0.05).The levels of GLS,GLS-endo,GLS-mid,GLS-epi,GCS and GRS in patients with ad-vanced gastric cancer after 6 cycles of chemotherapy were significantly lower than those after 3 cycles of chemotherapy(all P<0.05).After 6 cycles of chemotherapy,15 cases of advanced gastric cancer patients had cardiotoxic reactions and 91 cases did not have cardiotoxic reactions.The incidence of cardiotoxic reactions was 14.15%(15/106).Binary logistic regression analysis showed that decreased GLS,GLS-endo,GLS-epi,GCS,and GRS were independent risk factors for cardiotoxic reactions caused by chemotherapy for advanced gastric cancer(all P<0.05).ROC curve analysis showed that the AUC of GLS,GLS-endo,GLS-epi,GCS,and GRS in predicting chemotherapy-induced cardiotoxic reactions in patients with advanced gastric cancer were 0.739,0.779,0.668,0.712,and 0.760,respectively.The sensitivities were 68.1%,52.7%,85.7%,56.0%and 78.0%respec-tively,and the specificities were 86.7%,100.0%,46.7%,86.7%and 73.3%,respectively.Among them,GLS-endo had the largest AUC and the highest specificity in predicting chemotherapy-induced cardiotoxic reactions in patients with advanced gas-tric cancer,and GLS-epi had the highest sensitivity in predicting chemotherapy-induced cardiotoxic reactions in patients with ad-vanced gastric cancer.Conclusion Ultrasound 2D-STI can predict chemotherapy-induced cardiotoxic reactions in patients with advanced gastric cancer,which provides reliable imaging evidence for early clinical intervention.