左心室斑点追踪超声心动图变化在放射治疗后 3 年的早期乳腺癌患者中。
Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy.
机构信息
Heart and Lung Center, Helsinki University Central Hospital and Helsinki University, Helsinki, Finland
Faculty of Medicine and Life Sciences, Tampere University Hospital, University of Tampere and Heart Center, Tampere, Finland.
出版信息
Anticancer Res. 2019 Aug;39(8):4227-4236. doi: 10.21873/anticanres.13584.
BACKGROUND/AIM: Chest radiotherapy (RT) doubles late cardiac mortality. This study aimed to evaluate the evolution of cardiac changes in speckle tracking echocardiography during a three-year follow-up.
MATERIALS AND METHODS
This prospective study included 81 chemotherapy-naïve early-stage breast cancer patients who were evaluated at baseline, immediately after RT and three years after RT. Sixty-one patients had left-sided (LSBC) and 20 right-sided breast cancer (RSBC).
RESULTS
Global longitudinal strain (GLS) declined from baseline -18.0±3.3% to -17.0±3.0% (p=0.015) at the three-year follow-up examination. A decline over 15% (GLS15) was observed in 19 (27%) patients. GLS15 was independently associated with aromatase inhibitor use (β=-1.977, p=0.001). In regional analysis, patients with LSBC had apical strain decline by 3.2±5.5% (p<0.001) and patients with RSBC showed basal rotation decline by 1.8° (-0.2°, 3.8°) (p=0.030).
CONCLUSION
Even contemporary RT induced progressive global and regional decline in speckle tracking analysis. The regional changes complied with RT fields.
背景/目的：胸部放疗（RT）会使晚期心脏死亡率增加一倍。本研究旨在评估斑点追踪超声心动图在三年随访期间心脏变化的演变。
材料和方法
这项前瞻性研究纳入了 81 名未经化疗的早期乳腺癌患者，他们在基线时、RT 后立即和 RT 后三年进行了评估。61 名患者为左侧乳腺癌（LSBC），20 名患者为右侧乳腺癌（RSBC）。
结果
与基线时的-18.0±3.3%相比，三年随访时的整体纵向应变（GLS）下降至-17.0±3.0%（p=0.015）。19 名（27%）患者的 GLS 下降超过 15%（GLS15）。GLS15 与芳香酶抑制剂的使用独立相关（β=-1.977，p=0.001）。在区域分析中，LSBC 患者的心尖应变下降了 3.2±5.5%（p<0.001），RSBC 患者的基底旋转应变下降了 1.8°（-0.2°，3.8°）（p=0.030）。
结论
即使是当代的 RT 也会导致斑点追踪分析的全局和局部进行性下降。区域性变化与 RT 场相符。
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