Zhang Feng, Wang Siyuan, Liang Siying, Yu Chao, Li Sufang, Chen Hong, Wang Shu, Zhu Tiangang
Department of Cardiology, Peking University People's Hospital, Beijing, China.
Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Peking University People's Hospital, Beijing, China.
Cardiol Res Pract. 2021 Mar 2;2021:6640673. doi: 10.1155/2021/6640673. eCollection 2021.
Breast cancer patients with metabolic syndrome have an increased risk of cardiovascular disease. These patients are more prone to suffer from cardiotoxicity after anticancer therapy. Patients after completion of cancer-related comprehensive therapy, who show normal myocardial function, may already have subclinical myocardial dysfunction. We sought to evaluate the subclinical myocardial dysfunction in breast cancer patients with metabolic syndrome after cancer-related comprehensive therapy. Methods. In this study, 45 breast cancer patients with metabolic syndrome after completion of cancer-related comprehensive therapy, 45 non-breast cancer patients with metabolic syndrome, and 30 breast cancer patients without metabolic syndrome after therapy were enrolled. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) were measured using echocardiogram.
All the patients had normal LVEF. However, nine breast cancer patients with metabolic syndrome (20%) had GLS that was lower than -17%, while all the noncancer patients had normal GLS. Breast cancer patients with metabolic syndrome had a decrease of GLS and LVEF, compared with noncancer patients with metabolic syndrome. Furthermore, we found that decrease of age was associated with reduction of LVEF and that use of trastuzumab for 1 year was a significant factor associated with reduction of GLS. In addition, breast cancer patients with metabolic syndrome had a decrease of GLS, compared with breast cancer patients without metabolic syndrome after cancer-related therapy.
Breast cancer patients with metabolic syndrome after completion of cancer-related comprehensive therapy suffered from subclinical myocardial dysfunction. GLS should be routinely performed to early identify subclinical myocardial damage of patients, in order to prevent the cardiotoxicity of cancer-related comprehensive therapy.
患有代谢综合征的乳腺癌患者患心血管疾病的风险增加。这些患者在抗癌治疗后更容易出现心脏毒性。完成癌症相关综合治疗后心肌功能正常的患者可能已经存在亚临床心肌功能障碍。我们旨在评估癌症相关综合治疗后患有代谢综合征的乳腺癌患者的亚临床心肌功能障碍。方法。在本研究中，纳入了45例完成癌症相关综合治疗后的患有代谢综合征的乳腺癌患者、45例患有代谢综合征的非乳腺癌患者以及30例治疗后无代谢综合征的乳腺癌患者。使用超声心动图测量左心室射血分数（LVEF）和整体纵向应变（GLS）。
所有患者的LVEF均正常。然而，9例患有代谢综合征的乳腺癌患者（20%）的GLS低于-17%，而所有非癌症患者的GLS均正常。与患有代谢综合征的非癌症患者相比，患有代谢综合征的乳腺癌患者的GLS和LVEF有所下降。此外，我们发现年龄的降低与LVEF的降低相关，并且使用曲妥珠单抗1年是与GLS降低相关的一个重要因素。此外，与癌症相关治疗后无代谢综合征的乳腺癌患者相比，患有代谢综合征的乳腺癌患者的GLS有所下降。
完成癌症相关综合治疗后患有代谢综合征的乳腺癌患者存在亚临床心肌功能障碍。应常规进行GLS检查以早期识别患者的亚临床心肌损伤，从而预防癌症相关综合治疗的心脏毒性。
