Department of Echocardiography, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou 213003, China.
J Healthc Eng. 2022 Mar 24;2022:2590847. doi: 10.1155/2022/2590847. eCollection 2022.
In order to study the value of left atrial volume three-dimensional echocardiography in predicting cardiotoxicity in patients with multiple myeloma undergoing anthracycline chemotherapy, a total of 53 patients with multiple myeloma who are treated in the Department of Hematology of our hospital from January 2018 to December 2020 are selected as the research object, and all patients underwent three cycles (T1-T3) of chemotherapy. Before and after each cycle of chemotherapy, the patients are examined with 3D ultrasound and serology detection. These patients are divided into the cardiotoxicity group and noncardiotoxicity group. The serological indexes and three-dimensional echocardiographic parameters between two groups are compared. Multivariate logistic regression is used to determine the independent risk factors of cardiotoxicity in patients undergoing chemotherapy. And ROC curves are performed to evaluate the diagnostic value of related indicators in predicting cardiotoxicity. A total of 53 patients with multiple myeloma are included in this study. Serological indexes (T3 cTnI and T3 Pro-BNP), T2 LAVmin, T3 LAVmin, T2 LAVprep, and T3 LAVprep in the cardiotoxicity group are significantly higher than those in the noncardiotoxicity group. Multivariate logistic regression further found that T3 cTnI, T3 Pro-BNP, T2 LAV, T3 LAV, T2 LAV, T3 LAV could be used to predict the occurrence of cardiotoxicity ( < 0.05). The results of ROC curves showed that T3 LAV had the most diagnostic efficiency of cardiotoxicity (AUC = 0.938; sensitivity 75.72%; specificity 93.82%). Detection of changes in left atrial volume using three-dimensional ultrasound could be used as strong predictors of cardiotoxicity caused by anthracycline chemotherapy drugs in patients with multiple myeloma.
为了研究三维超声心动图左心房容积在预测接受蒽环类化疗的多发性骨髓瘤患者心脏毒性中的价值，选取 2018 年 1 月至 2020 年 12 月我院血液科收治的 53 例多发性骨髓瘤患者为研究对象，所有患者均接受 3 个周期（T1-T3）化疗。在每个化疗周期前后，患者均接受 3 维超声和血清学检测。根据患者是否发生心脏毒性，将患者分为心脏毒性组和非心脏毒性组，比较两组患者的血清学指标和三维超声心动图参数。采用多因素 logistic 回归确定化疗患者心脏毒性的独立危险因素，并进行 ROC 曲线分析，评价相关指标预测心脏毒性的诊断价值。本研究共纳入 53 例多发性骨髓瘤患者。心脏毒性组患者血清学指标（T3 cTnI 和 T3 Pro-BNP）、T2 LAVmin、T3 LAVmin、T2 LAVprep 和 T3 LAVprep 明显高于非心脏毒性组。多因素 logistic 回归进一步发现 T3 cTnI、T3 Pro-BNP、T2 LAV、T3 LAV、T2 LAV、T3 LAV 可用于预测心脏毒性的发生（ < 0.05）。ROC 曲线结果显示 T3 LAV 对心脏毒性的诊断效率最高（AUC=0.938；敏感度 75.72%；特异度 93.82%）。使用三维超声检测左心房容积变化可作为预测蒽环类化疗药物所致多发性骨髓瘤患者心脏毒性的有力指标。
