---
title: "2D Speckle-Tracking Echocardiography Detects Radiotherapy-Related Right Ventricular Dysfunction"
id: "pubmed-42907225"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42907225"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42907225/"
doi: "10.3760/cma.j.cn112148-20260811-00507"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "English Abstract"
license: "CC-BY-NC-4.0 / Informational Use"
---
# 2D Speckle-Tracking Echocardiography Detects Radiotherapy-Related Right Ventricular Dysfunction
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42907225
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42907225/)
- **DOI:** [10.3760/cma.j.cn112148-20260811-00507](https://doi.org/10.3760%2Fcma.j.cn112148-20260811-00507)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** English Abstract
## Executive GIST (TL;DR)
- Investigators enrolled 40 patients with thoracic tumors who received radiotherapy and underwent serial two-dimensional speckle-tracking echocardiography (**2D-STE**) at baseline, mid-treatment, and 1–2 days after completion of radiotherapy. - The study team measured left ventricular global longitudinal strain (**LVGLS**) and right ventricular free wall longitudinal strain (**RVFWLS**) and calculated ΔRVFWLS and percentage change in RVFWLS relative to baseline. - Right ventricular dysfunction was defined by objective Doppler/area criteria: right ventricular fractional area change (FAC) <35% or tricuspid annular systolic peak velocity <10 cm/s. - During treatment, mean FAC, **LVGLS**, and **RVFWLS** declined from baseline; these parameters remained lower than baseline after treatment (all P <0.05). - Multiple linear regression showed that **mean heart dose (MHD)** and patient age were linearly correlated with ΔRVFWLS and the percentage change in RVFWLS (P <0.05). - ROC analysis produced an AUC of 0.984 for **MHD** predicting right ventricular dysfunction with a reported cut-off of 2020 cGy; age AUC was 0.766 with a cut-off of 56.5 years. - Median follow-up was 82 days; 11 patients (28%) developed right ventricular dysfunction during that period. - Kaplan-Meier analysis indicated higher cumulative incidence of events for patients aged ≥56.5 years and for those with **MHD ≥2020 cGy** (log-rank P = 0.020 and P <0.001, respectively). - The authors reported that **2D-STE** enabled early detection of right ventricular dysfunction and identified patient age and **MHD** as associated risk factors.
## Clinical Analysis & Structured Key Points
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[ Full text links ](https://pubmed.ncbi.nlm.nih.gov/42907225/) ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42907225/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Experimental Resource Linked Discoveries ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42907225/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42907225/#abstract) * [ Conflict of interest statement ](https://pubmed.ncbi.nlm.nih.gov/42907225/#conflict-of-interest) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42907225/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42907225/#mesh-terms) * [ Grants and funding ](https://pubmed.ncbi.nlm.nih.gov/42907225/#grants) * [ LinkOut - more resources ](https://pubmed.ncbi.nlm.nih.gov/42907225/#linkout) Title & authors Abstract Conflict of interest statement Publication types MeSH terms Grants and funding LinkOut - more resources Zhonghua Xin Xue Guan Bing Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42907225/) . 2026 Oct 24;54(10):1198-1205. doi: 10.3760/cma.j.cn112148-20260811-00507. # [Two-dimensional speckle-tracking echocardiography in radiotherapy-related right heart dysfunction and analysis of associated risk factors] [Article in Chinese] [R Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+R&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#full-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [L A Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+LA&cauthor_id=42907225)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#full-view-affiliation-2 "Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [Z Q Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+ZQ&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#full-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [R L Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+RL&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#full-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China.") Affiliations Expand ### Affiliations * 1 Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China. * 2 Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China. * PMID: **42907225** * DOI: [ 10.3760/cma.j.cn112148-20260811-00507 ](https://doi.org/10.3760/cma.j.cn112148-20260811-00507) Item in Clipboard # [Two-dimensional speckle-tracking echocardiography in radiotherapy-related right heart dysfunction and analysis of associated risk factors] [Article in Chinese] R Liu et al. Zhonghua Xin Xue Guan Bing Za Zhi. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhonghua Xin Xue Guan Bing Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42907225/) . 2026 Oct 24;54(10):1198-1205. doi: 10.3760/cma.j.cn112148-20260811-00507. ### Authors [R Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+R&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#short-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [L A Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+LA&cauthor_id=42907225)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#short-view-affiliation-2 "Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [Z Q Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+ZQ&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#short-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China."), [R L Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+RL&cauthor_id=42907225)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907225/#short-view-affiliation-1 "Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China.") ### Affiliations * 1 Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China. * 2 Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China. * PMID: **42907225** * DOI: [ 10.3760/cma.j.cn112148-20260811-00507 ](https://doi.org/10.3760/cma.j.cn112148-20260811-00507) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42907225/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42907225/#zho-abstract) **Objective:** To evaluate the impact of radiotherapy on right ventricular function using two-dimensional speckle-tracking echocardiography (2D-STE) in patients with thoracic tumors, and to identify factors associated with radiotherapy-induced right ventricular dysfunction. **Methods:** Patients who received thoracic radiotherapy at the Fourth Hospital of Hebei Medical University between May 2021 and May 2022 were enrolled in this study. 2D-STE examinations were performed before, during (upon completion of half of the prescribed radiotherapy dose), and after radiotherapy (1 to 2days after the end of radiotherapy). The 2D-STE evaluation parameters included left ventricular global longitudinal strain (LVGLS) and right ventricular free wall longitudinal strain (RVFWLS). The difference between post-treatment RVFWLS and the baseline value (ΔRVFWLS) and the percentage change in RVFWLS were calculated. Right ventricular dysfunction was defined as a right ventricular fractional area change (FAC)<35% or tricuspid annular systolic peak velocity at the right ventricular free wall<10 cm/s. Multiple linear regression analysis was performed to investigate the associations of age, cardiac volume, radiotherapy parameters, and other factors with ΔRVFWLS and the percentage change in RVFWLS. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of the relevant factors for right ventricular dysfunction, and the Kaplan-Meier method was adopted for survival analysis. **Results:** A total of 40 patients were enrolled in this study, including 22 males, with a median age of 61.0 years. Compared with baseline, right ventricular FAC ((45.48±4.67)% vs. (51.75±6.55)%, _P_ <0.05), LVGLS ((-16.83±2.99)% vs. (-18.85±3.00)%, _P_ <0.05), and RVFWLS ((-25.69±2.29)% vs. (-28.86±1.26)%, _P_ <0.05) decreased during treatment. These parameters remained lower than the baseline levels after treatment (all _P_ <0.05). Multiple linear regression analysis demonstrated that mean heart dose (MHD) and patient age were linearly correlated with ΔRVFWLS and the percentage change in RVFWLS (all _P_ <0.05). ROC curve analysis revealed that the area under the curve (_AUC_) of MHD for predicting right ventricular dysfunction was 0.984, with a cut-off value of 2 020 cGy; the _AUC_ for patient age was 0.766, with a cut-off value of 56.5 years. The median follow-up duration was 82days, and 11 (28%) patients developed right ventricular dysfunction. The Kaplan-Meier survival curve indicated that the cumulative incidence of endpoint events was higher in patients aged ≥56.5 years than in those aged <56.5 years (_P_ log-rank=0.020). The cumulative incidence of endpoint events was higher in patients with an MHD ≥2 020 cGy than in those with an MHD <2 020 cGy _(P_ log-rank<0.001)_._ **Conclusions:** 2D-STE allows early detection of right ventricular dysfunction. Patient age and MHD are factors associated with radiotherapy-induced right ventricular dysfunction. **目的：** 探讨二维斑点追踪超声心动图（2D-STE）评估接受放射治疗（放疗）的胸部肿瘤患者早期右心功能损伤的价值，并分析右心功能损伤的相关因素。 **方法：** 选取2021年5月至2022年5月因胸部肿瘤在河北医科大学第四医院行放疗的患者。所有患者均于基线（放疗开始前）、治疗中（完成1/2的放疗处方剂量时）、治疗后（放疗结束后1~2 d）完成超声心动图检查。2D-STE评估指标包括左心室整体纵向应变和右心室游离壁纵向应变（RVFWLS）。计算治疗后的RVFWLS与基线值的差值（ΔRVFWLS），以及RVFWLS变化百分比。右心功能损伤定义为右心室面积变化分数<35%或右心室游离壁处三尖瓣收缩期峰值速度<10 cm/s。采用多重线性回归分析年龄、心脏体积、放疗参数等与ΔRVFWLS、RVFWLS变化百分比的关系。使用受试者工作特征曲线分析上述相关因素对右心功能损伤的预测效能，并通过Kaplan-Meier法进行生存分析。 **结果：** 入选40例患者，其中男性22例，中位年龄61.0岁。与基线比较，治疗中右心室面积变化分数［（45.48±4.67）%比（51.75±6.55）%， _P_ <0.05］、左心室整体纵向应变［（-16.83±2.99）%比（-18.85±3.00）%， _P_ <0.05］、RVFWLS［（-25.69±2.29）%比（-28.86±1.26）%， _P_ <0.05］即出现下降；治疗后上述指标仍低于基线（ _P_ 均<0.05）。多重线性回归分析结果显示，心脏平均剂量、患者年龄均与ΔRVFWLS、RVFWLS变化百分比呈线性相关（ _P_ 均<0.05）。受试者工作特征曲线显示，心脏平均剂量预测右心功能损伤的曲线下面积为0.984，界值为2 020 cGy；患者年龄的曲线下面积为0.766，界值为56.5岁。中位随访时间82 d，11例（28%）患者出现右心功能损伤。Kaplan-Meier生存曲线显示，年龄≥56.5岁的患者的心脏损伤累积发生率高于年龄<56.5岁的患者（ _P_ log-rank=0.020）。心脏平均剂量≥2 020 cGy患者的心脏损伤累积发生率高于心脏平均剂量<2 020 cGy的患者（ _P_ log-rank<0.001）。 **结论：** 2D-STE可早期检测右心功能损伤。患者年龄及心脏平均剂量是放疗致右心功能损伤的相关因素。. 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> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.