Tuohinen Suvi Sirkku, Keski-Pukkila Konsta, Skyttä Tanja, Huhtala Heini, Virtanen Vesa, Kellokumpu-Lehtinen Pirkko-Liisa, Raatikainen Pekka, Nikus Kjell
Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Anticancer Res. 2018 Apr;38(4):2207-2215. doi: 10.21873/anticanres.12463.
Early electrocardiogram (ECG) changes after breast cancer radiotherapy (RT) have been reported, but their characteristics and associated factors are largely unknown. This study aimed to explore early RT-induced ECG changes and to compare them with echocardiography changes.
Sixty eligible patients with chemotherapy-naïve left-sided and 20 with right-sided breast cancer were evaluated with echocardiography, blood samples and ECG before and after RT.
RT-induced ECG changes in the anterior leads. T-Wave changes were most frequent. T-Wave decline was associated independently with patient age (β=-0.245, p=0.005), mean heart radiation dose (β=1.252, p=0.001) and global systolic strain rate change (β=7.943, p=0.002). T-Wave inversion was associated independently with mean heart radiation dose (β=0.143, p<0.001), global longitudinal strain change (β=0.053, p=0.017) and posterior calibrated integrated backscatter (β=-0.022, p=0.049).
RT-induced ECG changes were prevalent and associated with functional and structural changes in echocardiography. ECG could be used for post-RT cardiac screening.
乳腺癌放疗（RT）后早期心电图（ECG）变化已有报道，但其特征及相关因素大多未知。本研究旨在探讨放疗引起的早期心电图变化，并将其与超声心动图变化进行比较。
对60例未经化疗的左侧乳腺癌患者和20例右侧乳腺癌患者在放疗前后进行超声心动图、血液样本及心电图评估。
放疗引起前壁导联心电图变化。T波改变最为常见。T波降低与患者年龄（β=-0.245，p=0.005）、平均心脏辐射剂量（β=1.252，p=0.001）及整体收缩应变率变化（β=7.943，p=0.002）独立相关。T波倒置与平均心脏辐射剂量（β=0.143，p<0.001）、整体纵向应变变化（β=0.053，p=0.017）及后壁校正后向散射积分（β=-0.022，p=0.049）独立相关。
放疗引起的心电图变化普遍存在，且与超声心动图的功能和结构变化相关。心电图可用于放疗后心脏筛查。
