Huang Jun, Yan Zi-Ning, Rui Yi-Fei, Shen Dan, Fan Li, Chen Dong-Liang
Department of Echocardiography, Changzhou No.2 People's Hospital Affiliated to NanJing Medical University, Changzhou 213003, China.
Oncotarget. 2017 Jul 26;8(41):70072-70083. doi: 10.18632/oncotarget.19585. eCollection 2017 Sep 19.
The study was to compare cardiac parameters before and after anthracycline-based chemotherapy and identify a parameter for detecting cardiotoxicity in breast cancer patients.
Cardiac function in 43 female breast cancer patients was evaluated at three time points: baseline, 1-3 days before the initiation of anthracycline-based chemotherapy; 3 weeks and 6 months after the final cycle of chemotherapy. At each visit, the peak longitudinal velocity; strain rate; peak systolic strain; peak systolic longitudinal displacement, and segmental and global longitudinal rotation degrees of the left ventricular were measured.
The peak early-diastole left ventricular wall velocity at baseline was significantly higher than the values at 3 weeks and 6 months after the final cycle of chemotherapy. The absolute value of the lateral wall peak systolic longitudinal rotation degrees was significantly higher at baseline than at 3 weeks and 6 months after the final cycle of chemotherapy, whereas the absolute value of the global peak systolic longitudinal rotation degrees at baseline was significantly lower than the values at 3 weeks and 6 months after the final cycle of chemotherapy. None of the measured parameters differed significantly between the 3 weeks and 6 months after the final cycle of chemotherapy.
Cardiac diastolic and systolic dysfunction was found after anthracycline-based chemotherapy in this study, and the peak systolic longitudinal rotation degrees can be used to detect dysfunction after chemotherapy. The cardiotoxicity of epirubicin-based chemotherapy is stronger than that of therarubicin-based chemotherapy.
本研究旨在比较蒽环类药物化疗前后的心脏参数,并确定一种检测乳腺癌患者心脏毒性的参数。
对43例女性乳腺癌患者的心脏功能在三个时间点进行评估:基线期,即开始蒽环类药物化疗前1 - 3天;化疗最后一个周期后3周和6个月。每次就诊时,测量左心室的纵向峰值速度、应变率、收缩期峰值应变、收缩期峰值纵向位移以及节段性和整体纵向旋转角度。
基线期左心室壁舒张早期峰值速度显著高于化疗最后一个周期后3周和6个月时的值。侧壁收缩期峰值纵向旋转角度的绝对值在基线期显著高于化疗最后一个周期后3周和6个月时的值,而基线期整体收缩期峰值纵向旋转角度的绝对值显著低于化疗最后一个周期后3周和6个月时的值。化疗最后一个周期后3周和6个月时,所测参数之间均无显著差异。
本研究发现蒽环类药物化疗后存在心脏舒张和收缩功能障碍,收缩期峰值纵向旋转角度可用于检测化疗后的功能障碍。表柔比星化疗的心脏毒性强于吡柔比星化疗。