ObjectiveTo evaluate the early changes of ventricular systolic function in patients with breast cancer by two-dimensional speckle tracking imaging（2 D-STI）during chemotherapy with trastuzumab

and to explore the value of 2 D-STI in the evaluation of chemotherapy-related early subclinical cardiotoxicity.MethodsA total of 89 patients with HER-2 positive breast cancer who were diagnosed in our hospital and received trastuzumab chemotherapy were selected.There were 3 chemotherapy cycles

each of which lasted for 3 weeks.According to whether cardiotoxicity happened during the chemotherapy cycle

89 patients were divided into cardiotoxicity group（n=22）and non-cardiotoxicity group（n=67）.The baseline level before chemotherapy（T0）

the first cycle（T1）

the second cycle（T2）and the third cycle（T3）were examined by echocardiography

and the routine echocardiography parameters were measured.The global longitudinal peak strains of left ventricle（LVGLS）and right ventricle（RVGLS）were measured by 2 D-STI.With the occurrence of cardiotoxicity in the course of chemotherapy as the clinical outcome

Logistic regression analysis and ROC curve analysis were used to analyze the predictive value of the parameters on the T1 cardiotoxicity associated with chemotherapy.ResultsLeft ventricular ejection fraction（LVEF）in T2

T3 and LVGLS

LVGCS

RVGLS in T1

T2

T3 of cardiotoxicity group were significantly lower than those of non-cardiotoxicity group（all P<0.05）. LVEF in T2 of cardiotoxicity grou was lower than 18% of T0

while LVGLS

LVGCS and RVGLS in T1 and T2 were significantly lower than those in T0（all P<0.05）.ROC curve and Logistic regression analysis showed that RVGLS combined with LVGLS in T1 was the best index to predict early subclinical cardiotoxicity associated with chemotherapy

the diagnostic sensitivity and specificity were 98% and 75%

respectively.ConclusionIn patients with breast cancer treated with trastuzumab who had no significant decrease in LVEF

LVGLS and RVGLS in T1 had been decreased. 2 D-STI is helpful for the early detection of chemotherapy-related subclinical cardiotoxicity.