儿童长期阿霉素心脏毒性：收缩状态和舒张期充盈的无创评估
Long term doxorubicin cardiotoxicity in childhood: non-invasive evaluation of the contractile state and diastolic filling.
作者信息
Hausdorf G, Morf G, Beron G, Erttmann R, Winkler K, Landbeck G, Keck E W
机构信息
Department of Paediatric Cardiology, University Hospital, Hamburg, Federal Republic of Germany.
出版信息
Br Heart J. 1988 Oct;60(4):309-15. doi: 10.1136/hrt.60.4.309.
Abstract
Cardiac performance was evaluated at least two years after doxorubicin treatment in childhood in 55 patients without overt congestive cardiomyopathy. None of the patients had received mediastinal irradiation. Computer-assisted analysis of digitised echocardiograms showed impaired rapid diastolic filling and an increased change of dimension between minimal cavity dimension and mitral valve opening. This impairment of diastolic function was related to the cumulative dose of doxorubicin. In contrast when angiotensin II was infused to increase the afterload the end systolic pressure-length and stress-shortening relation indicated normal left ventricular systolic function. But during baseline conditions the end systolic wall stress was significantly increased in patients in whom the cumulative dose of doxorubicin exceeded 360 mg/m2.
摘要
对55例儿童期接受阿霉素治疗后至少两年且无明显充血性心肌病的患者的心脏功能进行了评估。所有患者均未接受纵隔照射。对数字化超声心动图进行计算机辅助分析显示，快速舒张期充盈受损，最小腔径与二尖瓣开放之间的尺寸变化增加。舒张功能的这种损害与阿霉素的累积剂量有关。相比之下，当输注血管紧张素II以增加后负荷时，收缩末期压力-长度和应力-缩短关系表明左心室收缩功能正常。但在基线状态下，阿霉素累积剂量超过360mg/m²的患者收缩末期壁应力显著增加。
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