Pastore Alessandro, Geiger Sandra, Baur Dorothee, Hausmann Andreas, Tischer Johanna, Horster Sophia, Stemmler Hans Joachim
Med. Dept. III, Ludwig-Maximilians University of Munich, Campus Grosshadern, Munich, Germany.
Med. Dept. II, Ludwig-Maximilians University of Munich, Campus Grosshadern, Munich, Germany.
World J Oncol. 2013 Feb;4(1):18-25. doi: 10.4021/wjon635w. Epub 2013 Mar 6.
Anthracyclines are agents with a well known documented anti-tumoral activity. Cardiac side effects are the principal toxicity. Here we evaluate and monitor the onset of late anthracycline-induced cardiotoxicity with real-time CW-Doppler ultrasound cardiac output monitoring (USCOM®) and echocardiography in combination with serum biomarkers.
Fifty-two patients without cardiac disease who had received an anthracycline-based regimen for various cancer types were included in this study. Patients' hemodynamic parameters as stroke volume (SV USCOM (mL)) and ejection fraction (EF ECHOCARDIOGRAPHY (%)) were measured with USCOM and echocardiography and correlated to serum biomarkers (NT-pro-BNP and cTnT).
Eighteen patients (34.6%) developed cardiac disease (NYHA I-III). An increasing cumulative anthracycline dose was associated with a decrease of the EF determined by echocardiography as well the SV by USCOM and with a higher NYHA class. Those patients who experienced cardiac disease showed a reduction of the EF and SV and increased serum biomarkers.
Real-time CW-Doppler USCOM, is a fast and reliable method to monitor late hemodynamic changes as a symptom of anthracycline-induced cardiotoxicity comparable to the findings by echocardiography and serum biomarkers.
蒽环类药物是具有公认抗肿瘤活性的药物。心脏副作用是主要毒性。在此，我们采用实时连续波多普勒超声心输出量监测（USCOM®）和超声心动图结合血清生物标志物来评估和监测蒽环类药物诱导的晚期心脏毒性的发生情况。
本研究纳入了52例无心脏病且接受基于蒽环类药物方案治疗各种癌症类型的患者。使用USCOM和超声心动图测量患者的血流动力学参数，如每搏输出量（USCOM测量的SV（mL））和射血分数（超声心动图测量的EF（%）），并与血清生物标志物（NT-pro-BNP和cTnT）进行相关性分析。
18例患者（34.6%）发生心脏病（纽约心脏协会I-III级）。蒽环类药物累积剂量增加与超声心动图测定的EF降低以及USCOM测定的SV降低相关，且纽约心脏协会分级更高。那些发生心脏病的患者显示EF和SV降低，血清生物标志物升高。
实时连续波多普勒USCOM是一种快速且可靠的方法，可用于监测晚期血流动力学变化，作为蒽环类药物诱导的心脏毒性的症状，与超声心动图和血清生物标志物的结果相当。
