Noninvasive Left Ventricular Pressure-Strain Loop for Evaluating Changes in Left Ventricular Function in Colorectal Cancer Patients After Chemotherapy.

OBJECTIVE

To noninvasively monitor cardiac functional changes throughout chemotherapy in colorectal cancer patients using pressure-strain analysis, validate their predictive value for early detection of subclinical cardiac dysfunction.

METHODS

This retrospective observational study included colorectal cancer patients receiving FOLFOX/CAPEOX chemotherapy. Myocardial work parameters-including global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE)-were serially assessed using noninvasive pressure-strain loop technology at baseline (T0), after the first cycle (T1), mid-therapy (T2), and treatment completion (T3). Its predictive performance was evaluated by analyzing the trends of the aforementioned parameters and using receiver operating characteristic (ROC) curves.

RESULTS

Significant cardiac dysfunction emerged as early as the first chemotherapy cycle: GLS decreased by 8.7% (p < 0.001), GWI declined by 6.2% (p < 0.001), GWE reduced by 0.5% (p < 0.001), and GWW markedly increased (p < 0.001). The combined myocardial work model (GWI + GCW + GWE + GWW) predicted subclinical dysfunction with superior AUC (0.875) versus the GLS-only model (AUC = 0.813, p = 0.037).

CONCLUSIONS

FOLFOX/CAPEOX chemotherapy induces early myocardial mechanical inefficiency. Myocardial work parameters are sensitive monitoring markers, and their integrated model enhances early detection of subclinical cardiac injury.