Investigators performed serial two-dimensional speckle-tracking echocardiography (2D-STE) in patients receiving thoracic radiotherapy to evaluate early right ventricular injury. The cohort consisted of 40 patients treated between May 2021 and May 2022 at a single center. Examinations occurred at three prespecified time points: baseline (before radiotherapy), during treatment (after half of the planned dose), and immediately after treatment (1–2 days post-completion). The study team focused on deformation indices rather than symptoms alone, measuring left ventricular global longitudinal strain (LVGLS) and right ventricular free wall longitudinal strain (RVFWLS). The authors calculated absolute change (ΔRVFWLS) and percentage change from baseline as primary strain-change metrics.
The cohort showed measurable decline in traditional and deformation-based indices during radiotherapy. Right ventricular fractional area change (FAC) decreased during treatment from a baseline mean of (51.75±6.55)% to (45.48±4.67)% (P <0.05). Strain metrics also shifted: LVGLS fell from (-18.85±3.00)% at baseline to (-16.83±2.99)% during treatment (P <0.05), and RVFWLS dropped from (-28.86±1.26)% to (-25.69±2.29)% (P <0.05). These reductions persisted after treatment, with post-treatment values remaining statistically lower than baseline (all P <0.05). The authors defined right ventricular dysfunction using objective Doppler and area thresholds: FAC <35% or tricuspid annular systolic peak velocity at the right ventricular free wall <10 cm/s.
Multiple linear regression analysis identified two variables with linear correlations to ΔRVFWLS and percentage change in RVFWLS: mean heart dose (MHD) and patient age (all P <0.05). The study team reported these associations without additional causal claims; the statistical relationships indicate that higher MHD and older age were linked to greater strain deterioration, according to the model used in this dataset.
Receiver operating characteristic (ROC) analysis quantified predictive performance for right ventricular dysfunction. MHD produced an area under the curve (AUC) of 0.984 for predicting right ventricular dysfunction, with a reported cut-off value of 2020 cGy. Patient age had an AUC of 0.766 and a cut-off value of 56.5 years. Median follow-up in the cohort was 82 days. During that interval, 11 of 40 patients (28%) developed right ventricular dysfunction as defined by the study criteria. The Kaplan-Meier analysis showed higher cumulative incidence of endpoint events in patients aged ≥56.5 years compared with those <56.5 years (log-rank P = 0.020). Patients with MHD ≥2020 cGy experienced a higher cumulative incidence than those with MHD <2020 cGy (log-rank P <0.001).
The study included 40 patients, 22 of whom were male. The median age was 61.0 years. All patients underwent echocardiographic evaluation at baseline, at the mid-point of radiotherapy (completion of 1/2 of prescribed dose), and within 1–2 days after finishing radiotherapy. The authors reported a median follow-up duration of 82 days for event ascertainment. Imaging endpoints were strain-based (RVFWLS, LVGLS) and conventional functional indices (FAC, tricuspid annular velocity) as described above.
The published abstract reports design, key imaging time points, primary endpoints, statistical associations, and short-term outcomes. The source did not report certain operational details in the abstract: for example, it did not provide full multivariable model coefficients, detailed dose–volume histogram data beyond the reported MHD threshold, or longer-term follow-up beyond the median 82 days. The authors did not state additional trial limitations or prespecified next regulatory milestones in the abstract text. Readers should consult the full text for granular methodology, reproducibility metrics for 2D-STE measurements, and any center-specific radiotherapy planning parameters.
The study team concluded that 2D-STE permits early detection of right ventricular dysfunction after thoracic radiotherapy and that patient age and MHD were associated with radiotherapy-induced right-heart injury, according to the reported analyses. The abstract documents these findings and the short-term incidence of dysfunction but does not provide extended outcome data or further procedural details in the abstract itself.