Table 5.
Key Echocardiographic Recommendations for Best Practice
| Baseline assessment | Full BSE minimum dataset echocardiogram, vital signs, and GLS/3D volumes (Table 1) |
| Follow-up assessment | Targeted echocardiogram (Table 2) |
| If new symptoms, then full echocardiogram as per baseline assessment | |
| Definition of cardiotoxicity | LVEF: a decrease in LVEF by >10 absolute percentage points to a value <50% |
| Definition of probable cardiotoxicity by echocardiography | LVEF: decrease in LVEF by >10 absolute percentage points to a value ≥50% with an accompanying fall in GLS >15% (where GLS measurement available) |
| Definition of possible cardiotoxicity by echocardiography | LVEF: a decrease in LVEF by <10 absolute percentage points to a value <50% or LV GLS: when LVEF ≥50%, a relative percentage reduction in GLS by >15% |
| Poor endocardial definition | Consider contrast echocardiography when endocardial definition precludes the accurate assessment of LVEF (e.g., when a minimum of 2 contiguous LV segments from any apical view are not seen on noncontrast images) |
| Depending on local expertise and availability, CMR imaging is an alternative modality in this context |