The Clinical Value of Myocardial Work Index in Predicting Cardiovascular Events in Patients with Locally Advanced Non-small Cell Lung Cancer

LI Xiaochao; TIAN Su; WEN Chengfei

doi:10.12102/j.issn.1672-1349.2025.23.018

Abstract：Objective: To analyze the clinical value of global longitudinal strain (GLS) from echocardiography in predicting cardiovascular events in patients with locally advanced non-small cell lung cancer (NSCLC). Methods: A total of 59 patients with stage III NSCLC who received concurrent chemoradiotherapy at Changchun Tumor Hospital between June 2020 and April 2022 were enrolled. Electrocardiogram, transthoracic echocardiography, and cardiac biomarkers were assessed at the beginning of combined therapy, one month after chemoradiotherapy, and three months after chemoradiotherapy. Results: From baseline to one month and three months after chemoradiotherapy, GLS gradually increased (F=4.993, P=0.008), while left ventricular ejection fraction (LVEF) gradually decreased (F=3.397, P=0.036). GLS was significantly higher than baseline levels at three months (P=0.006), and LVEF was significantly lower than baseline levels (P=0.027). At baseline, one month, and three months after chemoradiotherapy, GLS was negatively correlated with LVEF (P<0.05). There were no significant changes in troponin I, creatine kinase isoenzyme, C-reactive protein, brain natriuretic peptide, corrected QTc interval (QTcF), and corrected QTc interval (QTcB) from baseline to one month and three months after chemoradiotherapy. During a median follow-up of 15.8 months after chemoradiotherapy, 14 patients (23.7%) experienced cardiovascular events. Cox regression analysis showed that baseline GLS and gender were independent risk factors for cardiovascular events after chemoradiotherapy (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) for predicting cardiovascular events after chemoradiotherapy using GLS was 0.772, with a sensitivity of 0.643 and a specificity of 0.872. Conclusion: Baseline GLS can serve as an independent risk factor for cardiovascular events after chemoradiotherapy in NSCLC patients and may be used to predict early cardiovascular events following chemoradiotherapy.