Wang Yan, Lu Congqing, Li Honge, Liu Kun, Yu Ming, Zhang Pingyang
Ultrasonography Department, the First People's Hospital of Lianyungang (Lianyungang Clinical Medical College of Nanjing Medical University), Lianyungang 222000, China.
UCardiology Department, the First People's Hospital of Lianyungang (Lianyungang Clinical Medical College of Nanjing Medical University), Lianyungang 222000, China.
Ann Palliat Med. 2020 May;9(3):1187-1197. doi: 10.21037/apm-20-1074.
Observation indexes used to evaluate the effect of dexrazoxane-anthracycline combinations in breast cancer often only take into account the clinical symptoms, or left ventricular ejection fraction (LVEF), biomarkers [such as creatine kinase MB (CK-MB), brain natriuretic peptide (BNP) and cardiac troponin T (cTnT)], or tumor recurrence rate, improvement of autonomic nerve function or economic benefits. This study aimed to evaluate the effect of dexrazoxane on the changes of mechanical properties of right ventricular myocardium in patients who underwent pirarubicin chemotherapy with three-dimensional speckle-tracking imaging (3D-STI).
A total of 64 breast cancer post-operation patients who received pirarubicin chemotherapy were randomly divided into two groups: the experimental group (with dexrazoxane added) and the control group (without dexrazoxane). The mechanical properties of the right ventricular myocardium were monitored by 3D-STI before and after chemotherapy. The levels of serum hypersensitive troponin I (hs-cTnI) and N-terminal B-type pro-natriuretic peptide (NT-proBNP) as well as conventional echocardiographic parameters were also measured.
After chemotherapy, right ventricular global longitudinal strain (RVGLS) and right ventricular global area strain (RVGAS) were significantly reduced in both groups (P<0.05). There was a significant difference between the two groups (P<0.05).
Dexrazoxane can alleviate the toxicity of pirarubicin in the right ventricular myocardium. 3D-STI is a potential new method for early and accurate evaluation of the mechanical properties and functional changes of the right ventricular myocardium.
用于评估右丙亚胺-蒽环类药物联合方案治疗乳腺癌效果的观察指标往往仅考虑临床症状、左心室射血分数（LVEF）、生物标志物[如肌酸激酶同工酶MB（CK-MB）、脑钠肽（BNP）和心肌肌钙蛋白T（cTnT）]，或肿瘤复发率、自主神经功能改善情况或经济效益。本研究旨在采用三维斑点追踪成像（3D-STI）评估右丙亚胺对接受吡柔比星化疗患者右心室心肌力学特性变化的影响。
将64例接受吡柔比星化疗的乳腺癌术后患者随机分为两组：实验组（加用右丙亚胺）和对照组（未加用右丙亚胺）。化疗前后采用3D-STI监测右心室心肌的力学特性。同时检测血清超敏肌钙蛋白I（hs-cTnI）和N末端B型利钠肽原（NT-proBNP）水平以及常规超声心动图参数。
化疗后，两组右心室整体纵向应变（RVGLS）和右心室整体面积应变（RVGAS）均显著降低（P<0.05）。两组间差异有统计学意义（P<0.05）。
右丙亚胺可减轻吡柔比星对右心室心肌的毒性。3D-STI是早期准确评估右心室心肌力学特性和功能变化的一种潜在新方法。
