Li Wenhuan, Liu Mingxi, Yu Fangfang, Jiang Tao, Zhu Weiwei, Liu He
Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing 100020, China.
Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing 100020, China.
Int J Cardiol. 2022 Feb 1;348:163-168. doi: 10.1016/j.ijcard.2021.12.006. Epub 2021 Dec 8.
Epicardial adipose tissue (EAT) as an endocrine organ, secreting hormones, and inflammatory cytokines is associated with adverse cardiovascular outcomes and may have a role in trastuzumab-induced cardiotoxicity (TIC). We sought to assess changes in EAT volume and radiodensity after receiving trastuzumab and if they are associated with TIC.
A total of 185 women treated with trastuzumab for human epidermal growth factor receptor 2-positive breast cancer were retrospectively recruited. All patients underwent echocardiography and CT before and during trastuzumab therapy. The time interval between CT and echocardiography was <10 days. EAT volume and density were quantified by CT. TIC was defined as a left ventricular ejection fraction (LVEF) decrease of >10% and < 53%.
Of the 185 patients, 18 (9.7%) experienced TIC. After receiving trastuzumab, EAT volume and radiodensity were increased, despite similar BMI. TIC group showed a significantly higher increment of EAT volume (21.2 ± 6.3 vs. 11.7 ± 10.5 ml, p < 0.001) and radiodensity (2.7 ± 1.8 vs. 1.5 ± 2.0HU, p < 0.05) than no TIC group. There was a high negative correlation between changes in EAT volume and LVEF (r = -0.70; p < 0.001) and a moderately negative correlation between changes in EAT radiodensity and LVEF (r = -0.50; p < 0.001). Increased EAT volume, but not radiodensity appeared to be a good imaging biomarker for TIC (AUC: 0.79 vs. 0.65, p < 0.05).
EAT volume and radiodensity were increased after receiving trastuzumab particularly in the TIC patients despite similar BMI. Notably, the increased EAT volume rather than radiodensity was strongly negatively associated with LVEF and appeared to be a good imaging biomarker of TIC.
心外膜脂肪组织（EAT）作为一个内分泌器官，分泌激素和炎性细胞因子，与不良心血管结局相关，并且可能在曲妥珠单抗诱导的心脏毒性（TIC）中起作用。我们试图评估接受曲妥珠单抗治疗后EAT体积和放射密度的变化，以及它们是否与TIC相关。
回顾性纳入了185例接受曲妥珠单抗治疗的人表皮生长因子受体2阳性乳腺癌女性患者。所有患者在曲妥珠单抗治疗前和治疗期间均接受了超声心动图和CT检查。CT检查和超声心动图检查的时间间隔<10天。通过CT对EAT体积和密度进行定量。TIC定义为左心室射血分数（LVEF）下降>10%且<53%。
185例患者中，18例（9.7%）发生了TIC。接受曲妥珠单抗治疗后，尽管BMI相似，但EAT体积和放射密度均增加。TIC组的EAT体积（21.2±6.3 vs. 11.7±10.5 ml，p<0.001）和放射密度（2.7±1.8 vs. 1.5±2.0 HU，p<0.05）的增加幅度显著高于非TIC组。EAT体积变化与LVEF之间存在高度负相关（r=-0.70；p<0.001），EAT放射密度变化与LVEF之间存在中度负相关（r=-0.50；p<0.001）。EAT体积增加而非放射密度增加似乎是TIC的一个良好影像学生物标志物（AUC：0.79 vs. 0.65，p<0.05）。
接受曲妥珠单抗治疗后，尤其是TIC患者，尽管BMI相似，但EAT体积和放射密度均增加。值得注意的是，EAT体积增加而非放射密度增加与LVEF呈强烈负相关，并且似乎是TIC的一个良好影像学生物标志物。
