ObjectiveTo evaluate the effect of anthracycline on right ventricular function in patients with breast cancer by automatic tracking of motion annular displacement（a TMAD）.MethodsFifty breast cancer patients receivd anthracycline-based chemotherapy were selected

two-dimensional echocardiograpy were performed before chemotherapy and after 2 nd and 4 th cycle of chemotherapy.The left ventricular ejection fraction（LVEF）

right ventricular fractional area change（RVFAC）

and tricuspid annular plane systolic excursion（TAPSE）were obtained.The global longitudinal peak strain of right ventricle（RVGLS）was obtained by two-dimensional speckle tracking technology.Tricuspid annulus displacement（TAD）was measured by a TMAD

and the peak systolic displacement of the free wall of the right ventricle of the tricuspid annulus（T1）

peak systolic displacement of the tricuspid annulus interval（T2）

peak displacement of the midpoint of the line of the tricuspid annulus（Tm）and the maximum longitudinal diameter ratio of Tm to the end diastolic of the right ventricle（Tm%）were obtained.The differences of the above parameters in each chemotherapy cycle were compared

and the correlations between the TAD andRVFAC

TAPSE

RVGLS were analyzed

and the correlation between the ultrasonic parameters and the accumulated dose ofanthracycline were compared.Receiver operating characteristic（ROC）curves were drawn to analyze the diagnostic efficacy ofultrasonic parameters in predicting cardiac toxicity of anthracyclines

and RVGLS and Tm% were tested for repeatability.Results（1） Compared with before chemotherapy

LVEF

RVFAC and TAPSE were decreased after the 4 th cycle ofchemotherapy

while RVGLS

T1

T2

Tm and Tm% were decreased after the 2 nd and 4 th cycles of chemotherapy

the differenceswere statistically significant（all P<0.05）.（2）There were strong correlation between Tm% and RVGLS（r=0.848

0.748

0.795

allP<0.05）

and a weak correlation with RVFAC（r=0.544

0.447

0.347

all P<0.05）and weak correlation with TAPSE（r=0.436

0.291

0.305

all P<0.05）in each cycle before and after chemotherapy.RVGLS

T1

T2

Tm and Tm% were negatively correlatedwith drug accumulated doses（r=-0.785

-0.852

-0.730

-0.765

-0.862

all P<0.05）.（3）ROC curve analysis showed that thecutoff value of RVGLS for predicting cardiac toxicity of anthracyclines was 18.35%

the diagnostic sensitivity was 90.7%

specificity was 85.7%

and area under the curve was 0.942.The cut-off value of Tm% was 15.15%

the diagnostic sensitivity was95.3%

specificity was 85.7%

and area under the curve of 0.930.（4）Reproducibility tests showed that the intra-observer ICC forRVGLS and Tm% were 0.891 and 0.937

and the inter-observer ICC were 0.850 and 0.890

respectively.Conclusiona TMADcan be used to evaluate right ventricular global systolic dysfunction in patients with breast cancer received chemotherapy

andTm% is more convenient than RVGLS

which is repeatable and worthy of clinical promotion.