Ha Jong-Won, Kang Seok-Min, Pyun Wook-Bum, Lee Joo-Yong, Ahn Mi-Young, Kang Woong-Chul, Jeon Tae Joo, Chung Namsik, Lee Jong-Doo, Cho Sang-Ho
Cardiology Division, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2005 Feb 28;46(1):73-7. doi: 10.3349/ymj.2005.46.1.73.
Although adriamycin (Doxorubicin) is one of the most effective and useful antineoplastic agents for the treatment of a variety of malignancies, its repeated administration can induce irreversible myocardial damage and resultant heart failure. Currently, no marker to detect early cardiac damage is available. The purpose of this study was to investigate whether an assessment of the acoustic properties of the myocardium could enable the earlier detection of myocardial damage after adriamycin chemotherapy. Forty Wistar rats were treated with adriamycin (2 mg/kg, i.v.) once a week for 2, 4, 6 or 8 weeks consecutively. Left ventricular ejection fraction (LVEF) was calculated using M-mode echocardiography data. The magnitude of cardiac cycle dependent variation of integrated backscatter (CVIB) of the myocardium was measured in the mid segment of the septum and in the posterior wall of the left ventricle, using a real time two dimensional integrated backscatter imaging system. LVEF was significantly lower in the adriamycin-treated 8-week group than in the controls (75+/-9 vs 57+/-8%, p<0.05). Myocyte damage was only seen in the 8-week adriamycin-treated group. However, no significant changes of CVIB were observed between baseline or during follow-up in the ADR or control group. In conclusion, serial assessment of the acoustic properties of the myocardium may not be an optimal tool for the early detection of myocardial damage after doxorubicin chemotherapy in a rat model.
尽管阿霉素(多柔比星)是治疗多种恶性肿瘤最有效且有用的抗肿瘤药物之一,但其重复给药会导致不可逆的心肌损伤并引发心力衰竭。目前,尚无用于检测早期心脏损伤的标志物。本研究的目的是调查评估心肌声学特性是否能够在阿霉素化疗后更早地检测到心肌损伤。40只Wistar大鼠连续2、4、6或8周每周一次静脉注射阿霉素(2mg/kg)。使用M型超声心动图数据计算左心室射血分数(LVEF)。使用实时二维背向散射积分成像系统,在室间隔中段和左心室后壁测量心肌背向散射积分(CVIB)的心动周期依赖性变化幅度。阿霉素治疗8周组的LVEF显著低于对照组(75±9 vs 57±8%,p<0.05)。仅在阿霉素治疗8周组观察到心肌细胞损伤。然而,阿霉素组或对照组在基线或随访期间CVIB均未观察到显著变化。总之,在大鼠模型中,对心肌声学特性进行系列评估可能不是阿霉素化疗后早期检测心肌损伤的最佳工具。