急性髓系白血病患者左心室功能及亚临床动脉粥样硬化的评估
The Assessment of Left Ventricle Function and Subclinical Atherosclerosis in Patients with Acute Myeloid Leukemia.
作者信息
Militaru Anda, Avram Adina, Cimpean Anca Maria, Iurciuc Mircea, Matusz Petru, Lighezan Daniel, Militaru Marius
机构信息
Medical Semiology I, Department of Internal Medicine I, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
出版信息
In Vivo. 2018 Nov-Dec;32(6):1599-1607. doi: 10.21873/invivo.11420.
UNLABELLED
Aim To assess the onset of early left ventricular (LV) systolic and diastolic function impairment and the subclinical atherosclerosis following chemotherapy in patients diagnosed with acute myeloid leukemia (AML).
MATERIALS AND METHODS
Thirty patients diagnosed with AML with no cardiac history, having LV ejection fraction (LVEF) >50%, were evaluated at baseline and 6 months after starting four cycles of chemotherapy. We measured LV function, global longitudinal strain and subclinical atherosclerosis markers: intima-media thickness (IMT), arterial stiffness aortic pulse wave velocity (PWVAo) and ankle-brachial index (ABI).
RESULTS
LVEF had decreased at 6 months after treatment initialization (p<0.001), the same changes being observed for LV fraction shortening (p<0.001), mitral annular plane systolic excursion and S' wave (p<0.001 and p<0.05). Bilateral IMT and PWVAo significantly increased, 12 out of 30 patients (40%) had LVEF ≤50% after 6 months of chemotherapy, five of them receiving daunorubicin at more than 500 mg/m/injection.
CONCLUSION
LV function is impaired after 6 months of chemotherapy, with early changes of subclinical atherosclerosis becoming evident.
未标注
目的是评估急性髓系白血病（AML）患者化疗后早期左心室（LV）收缩和舒张功能损害的发生情况以及亚临床动脉粥样硬化。
材料与方法
30例诊断为AML且无心脏病史、左心室射血分数（LVEF）>50%的患者，在基线时以及开始四个周期化疗后的6个月进行评估。我们测量了左心室功能、整体纵向应变和亚临床动脉粥样硬化标志物：内膜中层厚度（IMT）、动脉僵硬度主动脉脉搏波速度（PWVAo）和踝臂指数（ABI）。
结果
治疗开始后6个月LVEF降低（p<0.001），左心室缩短分数（p<0.001）、二尖瓣环平面收缩期位移和S波（p<0.001和p<0.05）也有相同变化。双侧IMT和PWVAo显著增加，30例患者中有12例（40%）在化疗6个月后LVEF≤50%，其中5例接受柔红霉素剂量超过500mg/m/次注射。
结论
化疗6个月后左心室功能受损，亚临床动脉粥样硬化的早期变化变得明显。
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