Medical College of Shihezi University, Department of Ultrasonography, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China.
Department of Cardiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China.
J Clin Ultrasound. 2021 May;49(4):378-384. doi: 10.1002/jcu.22941. Epub 2020 Dec 28.
To investigate the clinical value of three-dimensional speckle tracking imaging (3D-STI) in evaluating left ventricular (LV) systolic function in patients with ovarian cancer (OC) treated with paclitaxel and carboplatin.
We studied 30 patients with OC treated with paclitaxel combined with carboplatin chemotherapy. Two-dimensional echocardiography and 3D-STI were performed in the patients before they underwent 2- and 6-cycle chemotherapies, and in 30 normal control subjects. Were measured LV end-diastolic volume (EDV), end-systolic volume (ESV), three-dimensional LV ejection fraction (3D-LVEF), stroke volume (SV), spherical index (SPI), LV end-diastolic mass (LV EDmass), LV end-systolic mass (LV ESmass), LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS) and cardiac troponin T(cTnT). At the end of chemotherapy, magnetic resonance imaging (MRI) was also performed.
The 3D conventional strain values (3D-LVEF, SV, LV EDV) after the 2- and 6-cycle chemotherapy were lower than before chemotherapy. LV Edmass, LV ESmass and cTnT were higher while LV GLS, GCS, GRS, GAS were lower after 2- and after 6-cycle chemotherapy than before chemotherapy. There was no significant difference in ESV and EDV between the 3D-STI and MRI parameters. GAS showed a significant negative correlation with cTnT. MRI and 3D-STI variables were significantly correlated, and the receiver operating characteristic curves showed the greater area under the curve for GAS after 2- and after 6-cycle chemotherapy. After 2-cycle chemotherapy, the highest specificity for GAS was 93.3%, and the highest sensitivity for GLS was 70.0%. After 6-cycle chemotherapy, the highest specificity for GAS was 96.7%, and the highest sensitivity for GLS was 96.7%.
The LV systolic function decreased in OC patients treated with paclitaxel and carboplatin, showing that 3D-STI may detect early LV systolic dysfunction.
探讨三维斑点追踪成像（3D-STI）评价紫杉醇联合卡铂化疗的卵巢癌（OC）患者左心室（LV）收缩功能的临床价值。
选取 30 例接受紫杉醇联合卡铂化疗的 OC 患者，在化疗前、化疗 2 个周期后、化疗 6 个周期后及 30 例健康体检者行二维超声心动图及 3D-STI 检查，测量左心室舒张末期容积（EDV）、收缩末期容积（ESV）、三维左心室射血分数（3D-LVEF）、每搏量（SV）、球形指数（SPI）、左心室舒张末期质量（LV EDmass）、左心室收缩末期质量（LV ESmass）、左心室整体纵向应变（GLS）、整体圆周应变（GCS）、整体径向应变（GRS）、整体面积应变（GAS）及心肌肌钙蛋白 T（cTnT）。化疗结束后行心脏磁共振（MRI）检查。
化疗 2 个周期及 6 个周期后 3D 常规应变值（3D-LVEF、SV、LV EDV）较化疗前降低，LV Edmass、LV ESmass 及 cTnT 较化疗前升高，LV GLS、GCS、GRS、GAS 较化疗前降低，差异均有统计学意义（均 P<0.05）。3D-STI 与 MRI 各参数间 ESV、EDV 差异无统计学意义。GAS 与 cTnT 呈明显负相关。MRI 与 3D-STI 各变量间呈显著相关性，且化疗 2 个周期及 6 个周期后 GAS 的曲线下面积较大。化疗 2 个周期后，GAS 诊断效能最高，特异度为 93.3%，灵敏度为 70.0%；化疗 6 个周期后，GAS 诊断效能最高，特异度为 96.7%，灵敏度为 96.7%。
紫杉醇联合卡铂化疗的 OC 患者左心室收缩功能降低，3D-STI 可能早期检测 LV 收缩功能障碍。
