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三维斑点追踪超声心动图评估接受蒽环类药物治疗的淋巴瘤患者左心室扭转功能的早期变化。

The early variation of left ventricular twisting function in patients with lymphoma received anthracycline therapy assessed by three-dimensional speckle tracking echocardiography.

作者信息

Song Feiyan, Kang Yu, Zhang Chujie, Xu Yuchen, Shi Jing, Guo Ye, Zhang Qunling, Shu Xianhong, Cheng Leilei

机构信息

Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.

出版信息

Cardiol J. 2017;24(5):484-494. doi: 10.5603/CJ.a2017.0035. Epub 2017 Mar 29.

Abstract

BACKGROUND

Anthracycline-induced cardiotoxicity remains a significant and unresolved issue in patients receiving chemotherapy. The aim of this study was to evaluate left ventricular (LV) twisting function by three-dimensional speckle tracking echocardiography (3D-STE) in patients with lymphoma after anthracycline therapy.

METHODS

One hundred and one patients with newly diagnosed diffuse large B-cell lymphoma who had planned to receive anthracycline chemotherapy were enrolled. LV apical rotation, basal rotation, twist, torsion, time to peak apical rotation and time to peak basal rotation were measured by 3D-STE at baseline, after the completion of two cycles and four cycles of the regimen, respectively. Apical-basal rotation delay was calculated as the difference between time to basal and time to apical rotation.

RESULTS

The results showed that LV apical rotation, basal rotation, twist and torsion declined progressively during the whole procedure (baseline vs. two and four cycles of the regimen, apical rotation: 12.5 ± ± 4.5° vs. 8.8 ± 3.6° vs. 6.0 ± 3.2°; basal rotation: -7.7 ± 3.0° vs. -5.9 ± 2.6° vs. -4.4 ± 2.5°; twist: 20.0 ± 6.4° vs. 14.5 ± 5.1° vs. 9.8 ± 4.5°; torsion: 2.9 ± 0.9°/cm vs. 2.1 ± 0.9°/cm vs. 1.4 ± 0.7°/cm; all p < 0.01). Furthermore, apical-basal rotation delay increased significantly after two cycles as well as after four cycles of the regimen (38.3 ± 67.9 ms vs. 66.7 ± 73.9 ms vs. 92.6 ± 96.9 ms; p < 0.01).

CONCLUSIONS

LV twisting function deteriorated in the early stage of anthracycline therapy in patients with lymphoma, which could be detected by 3D-STE sensitively.

摘要

背景

在接受化疗的患者中,蒽环类药物所致心脏毒性仍然是一个重大且尚未解决的问题。本研究旨在通过三维斑点追踪超声心动图(3D-STE)评估蒽环类药物治疗后淋巴瘤患者的左心室(LV)扭转功能。

方法

纳入101例计划接受蒽环类化疗的新诊断弥漫性大B细胞淋巴瘤患者。分别在基线、完成两个周期和四个周期化疗方案后,通过3D-STE测量左心室心尖旋转、基底旋转、扭转、扭矩、心尖旋转峰值时间和基底旋转峰值时间。心尖-基底旋转延迟计算为基底旋转时间与心尖旋转时间之差。

结果

结果显示,在整个过程中,左心室心尖旋转、基底旋转、扭转和扭矩逐渐下降(基线与化疗方案的两个周期和四个周期相比,心尖旋转:12.5±4.5° vs. 8.8±3.6° vs. 6.0±3.2°;基底旋转:-7.7±3.0° vs. -5.9±2.6° vs. -4.4±2.5°;扭转:20.0±6.4° vs. 14.5±5.1° vs. 9.8±4.5°;扭矩:2.9±0.9°/cm vs. 2.1±0.9°/cm vs. 1.4±0.7°/cm;均p<0.01)。此外,化疗方案两个周期及四个周期后,心尖-基底旋转延迟均显著增加(38.3±67.9 ms vs. 66.7±73.9 ms vs. 92.6±96.9 ms;p<0.01)。

结论

淋巴瘤患者在蒽环类药物治疗早期左心室扭转功能恶化,3D-STE可敏感检测到这种变化。

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