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采用三维斑点追踪成像技术评价多发性骨髓瘤患者 PAD 方案前后的心脏功能。

Evaluation of Cardiac Function before and after PAD Regimen in Patients with Multiple Myeloma by Three-Dimensional Speckle Tracking Imaging.

机构信息

The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, Department of Echocardiography, Changzhou, Jiangsu 213003, China.

出版信息

J Healthc Eng. 2022 Jan 27;2022:1849969. doi: 10.1155/2022/1849969. eCollection 2022.

Abstract

In this manuscript, we have evaluated numerous changes of cardiac function in patients with multiple myeloma before and after PAD chemotherapy with 3D speck tracking imaging (3D-STI). For this purpose, 39 patients with multiple myeloma, from July 2019 to December 2020, who received the PAD regimen (bortezomib + doxorubicin liposome + dexamethasone, a course of 12 days) were selected as subjects. A comparison of two-dimensional conventional echocardiographic parameters before and after chemotherapy and 3D-STI related parameters was carried out. After 6 cycles of chemotherapy, the levels of TAPSE, RVFAC, and LVEF were significantly lower than those before chemotherapy ( < 0.05). There was no significant difference in the results of left and right ventricle two-dimensional conventional echocardiography before chemotherapy and 2 or 4 cycles after chemotherapy ( > 0.05). There were significant differences in the levels of RVGCS, RVGLS, RVGRS, LVGLS, and LVGRS before and after chemotherapy ( < 0.05). Specifically, RVGCS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; RVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < after 2 cycles of chemotherapy < before chemotherapy; RVGRS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; LVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; and LVGRS: after 6 cycles of chemotherapy < before chemotherapy. The results of Pearson correlation analysis showed that the dose of doxorubicin was negatively correlated with RVGCS, RVGLS, RVGRS, and LVGLS, but not with TAPSE, RVFAC, LVEF, and LVGRS. 3D-STI is helpful for early detection of the changes of left and right ventricular myocardial function after PAD chemotherapy in patients with multiple myeloma. And the early screening value of the RVGLS parameter is higher.

摘要

在本手稿中,我们使用 3D 斑点追踪成像(3D-STI)评估了多发性骨髓瘤患者在 PAD 化疗前后的心脏功能的多项变化。为此,选择了 2019 年 7 月至 2020 年 12 月期间接受 PAD 方案(硼替佐米+脂质体阿霉素+地塞米松,12 天一个疗程)的 39 名多发性骨髓瘤患者作为研究对象。比较了化疗前后二维常规超声心动图参数和 3D-STI 相关参数。化疗 6 个周期后,TAPSE、RVFAC 和 LVEF 水平明显低于化疗前(<0.05)。化疗前与化疗后 2 个或 4 个周期的左、右心室二维常规超声心动图结果无统计学差异(>0.05)。化疗前后 RVGCS、RVGLS、RVGRS、LVGLS 和 LVGRS 水平差异有统计学意义(<0.05)。具体而言,RVGCS:化疗 6 个周期后<化疗 4 个周期后<化疗前;RVGLS:化疗 6 个周期后<化疗 4 个周期后<化疗 2 个周期后<化疗前;RVGRS:化疗 6 个周期后<化疗 4 个周期后<化疗前;LVGLS:化疗 6 个周期后<化疗 4 个周期后<化疗前;LVGRS:化疗 6 个周期后<化疗前。Pearson 相关性分析结果显示,阿霉素剂量与 RVGCS、RVGLS、RVGRS 和 LVGLS 呈负相关,与 TAPSE、RVFAC、LVEF 和 LVGRS 无相关性。3D-STI 有助于早期发现多发性骨髓瘤患者 PAD 化疗后左、右心室心肌功能的变化,RVGLS 参数的早期筛查价值更高。

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