As the survival rates and lifespans of cancer patients continue to increase, chemotherapy-related cardiotoxicity has become a critical concern ^{[1, 2]}.  Chemotherapy is a key treatment of gynecologic cancers ^[3], but several commonly used chemotherapy drugs have been reported to cause cardiotoxicity and myocardial dysfunction ^[4]. Therefore, early assessment and monitoring of cardiac function are essential for patients with gynecologic cancer undergoing chemotherapy.

Clinically, left ventricular ejection fraction (LVEF), which reflects left ventricular systolic function, remains the gold standard for assessing ventricular function during and after cancer therapy. However, LVEF may be insufficient for detecting subclinical cardiac dysfunction ^[5]. 

Cardiac magnetic resonance (CMR) myocardial strain values have emerged as a more promising and sensitive index for estimating ventricular systolic function^[6,7]. CMR tissue tracking is a promising contrast-free quantitative method which is based on CMR cine sequence images to quantify global and segmental myocardial strain^[7]. Previous studies have applied CMR tissue tracking to monitor chemotherapy-associated cardiotoxicity ^[8-12], demonstrating that CMR global longitudinal strain (GLS) and global circumferential strain (GCS) can detect and predict early cardiac dysfunction. However, there is a lack of research on myocardial deformation in patients with gynecologic cancer undergoing chemotherapy. Therefore, this study aimed to assess left ventricular (LV) myocardial deformation in patients with gynecologic cancer undergoing chemotherapy using CMR tissue tracking and to investigate the association between LV myocardial deformation and chemotherapy factors.