使用二维斑点追踪超声心动图早期检测蒽环类药物诱导的心脏毒性。
Early detection of anthracycline-induced cardiotoxicity using two-dimensional speckle tracking echocardiography.
机构信息
Department of Cardiology, Renji Hospital of Jiaotong University, Shanghai, China Department of Echocardiography, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, China.
出版信息
Cardiol J. 2013;20(6):592-9. doi: 10.5603/CJ.2013.0158.
BACKGROUND
To examine the subclinical myocardial injury shortly after epirubicin exposure in asymptomatic patients with large B-cell non-Hodgkin lymphoma using 2-dimensional (2D) speckle tracking echocardiography.
METHODS
Sixty-seven patients aged 52.58 ± 13.86 years with large B-cell non-Hodgkin lymphoma treated with epirubicin were studied. Echocardiography was performed at baseline and 1 day after completion of the therapy. Global and regional longitudinal (LS), circumferential (CS) and radial strain (RS), standard deviation of time to peak LS (TLS-SD), CS (TCS-SD), RS(TRS-SD) were calculated using 2D speckle tracking echocardiography.
RESULTS
Despite normal left ventricular ejection fraction, global LS (-18.30 ± 1.87% vs.-16.18 ± 1.92%; p < 0.01), CS (-20.37 ± 2.89% vs. -18.25 ± 2.40%, p < 0.01) and RS (39.95 ± 5.79% vs. 36.15 ± 5.79%, p < 0.01), were remarkably reduced compared to baseline values. However, TLS-SD, TCS-SD and TRS-SD showed no significant difference after epirubicin exposure. Hypertension was an independent predictor of reduction of global LS, CS and RS.
CONCLUSIONS
Subtle abnormalities in myocardial systolic function were present in asymptomatic patients shortly after anthracycline exposure, which could be detected by 2D speckle tracking echocardiography.
背景
使用二维（2D）斑点追踪超声心动图检查接受表柔比星治疗的无症状大 B 细胞非霍奇金淋巴瘤患者在接触表柔比星后不久的亚临床心肌损伤。
方法
研究了 67 名年龄 52.58±13.86 岁、接受表柔比星治疗的大 B 细胞非霍奇金淋巴瘤患者。在基线和治疗完成后 1 天进行超声心动图检查。使用二维斑点追踪超声心动图计算整体和节段纵向（LS）、周向（CS）和径向应变（RS）、LS 达峰时间标准差（TLS-SD）、CS（TCS-SD）、RS（TRS-SD）。
结果
尽管左心室射血分数正常，但与基线值相比，整体 LS（-18.30±1.87% vs.-16.18±1.92%，p<0.01）、CS（-20.37±2.89% vs.-18.25±2.40%，p<0.01）和 RS（39.95±5.79% vs. 36.15±5.79%，p<0.01）显著降低。然而，在接触表柔比星后，TLS-SD、TCS-SD 和 TRS-SD 没有显示出显著差异。高血压是整体 LS、CS 和 RS 降低的独立预测因素。
结论
在接触蒽环类药物后不久，无症状患者的心肌收缩功能就出现了细微异常，二维斑点追踪超声心动图可以检测到这些异常。
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