Ultrasound machines

Patients underwent echocardiography at baseline prior to starting anthracycline therapy, and again at 3 and 6 months after completing chemotherapy, which included doxorubicin. The echocardiograms were obtained using GE Ultrasound System and Philips Ultrasound Machines and included 3–5 cardiac cycles of 4-, 3-, and 2-chamber apical views. The images were digitally stored in raw format for later analysis. LVGLS was analyzed using a semiautomated speckle tracking technique (TOMTEC Imaging system GmbH Freisinger Strasse9, 85716 Unterschleissheim Germany) with a model of the entire left ventricle, including the 3 apical views. Inadequately tracked segments were excluded from the analysis. Two different observers analyzed the datasets and measured the left ventricular global longitudinal strain (LVGLS) using TOMTEC. Each observer analyzed the dataset twice, with the second review taking place 3 months after the first. The observers were blinded to each other during the analysis, and the second measurement of each observer was used to evaluate intraobserver reproducibility.

The diagnosis of EVs was based on the 2008 Hangzhou consensus proposed by the Chinese Society of Gastroenterology, Chinese Society of Hepatology, and Chinese Society of Digestive Endoscopy. These criteria were derived from the AASLD practice guidelines, Baveno consensus, and Japanese Society for Portal Hypertension guidelines (12 (link), 14 (link), 22 (link)–24 (link)). Patients were listed as having no, mild, moderate, or severe varices as in previous reports (12 (link), 14 (link)). Spleen size was routinely measured and reported on ultrasound examinations (Philips Ultrasound Machines) at The Second People's Hospital, Fuyang and other participation centers by experienced medical doctors. The formulas for the non-invasive scores utilized are reported below. The Child-Pugh score for Cirrhosis Mortality was also calculated (25 –27 (link)).