Dong Yingjun, Wu Qiong, Hu Changqing
Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Department of Cardiology, Shanxi Provincial People's Hospital, Taiyuan, China.
Front Surg. 2022 Jul 1;9:898172. doi: 10.3389/fsurg.2022.898172. eCollection 2022.
Determine the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) combined with echocardiography in the diagnosis of anthracyclines-induced chronic cardiotoxicity.
A total of 80 female breast cancer patients from January 2019 to October 2021 were included in our hospital. Twenty-six patients with cardiotoxicity were divided into the cardiac impairment group, and the 54 patients without cardiotoxicity were classified into the normal control group. NT-proBNP levels and cardiac echocardiography were measured before the start of the chemotherapy cycle, in cycle 3 of the chemotherapy, and after the chemotherapy cycle in all patients.
After three cycles of chemotherapy and chemotherapy, the levels of NT-proBNP in patients of the two groups were significantly higher than those before chemotherapy (< 0.05). The levels of NT-proBNP in the cardiac injury group after three cycles of chemotherapy and chemotherapy were higher than those in the normal control group at the same time point (< 0.05). The LVEF of patients in the cardiac impairment group after chemotherapy was lower than that before chemotherapy, and the LVEF after chemotherapy was lower than that in the normal control group (< 0.05). NT-proBNP had a negative correlation with LVEF (= -0.549, < 0.001). The AUC of NT-proBNP in combination with LVEF for predicting cardiotoxicity in our patient was 0.898(95%CI:0.829-0.966).
NT-proBNP combined with echocardiography has clinical significance in the detection of anthracyclines-induced cardiotoxicity, and it can detect early myocardial injury induced by anthracyclines, with early prediction value. It is important to protect heart function and judge prognosis.
确定N末端B型利钠肽原（NT-proBNP）联合超声心动图在蒽环类药物所致慢性心脏毒性诊断中的预测价值。
选取2019年1月至2021年10月在我院就诊的80例女性乳腺癌患者。将26例发生心脏毒性的患者分为心脏损害组，54例未发生心脏毒性的患者分为正常对照组。所有患者在化疗周期开始前、化疗第3周期以及化疗周期结束后均检测NT-proBNP水平并进行心脏超声心动图检查。
化疗3周期及化疗结束后，两组患者的NT-proBNP水平均显著高于化疗前（<0.05）。化疗3周期及化疗结束后，心脏损害组患者的NT-proBNP水平高于正常对照组在同一时间点的水平（<0.05）。心脏损害组患者化疗后的左心室射血分数（LVEF）低于化疗前，且化疗后的LVEF低于正常对照组（<0.05）。NT-proBNP与LVEF呈负相关（r=-0.549，P<0.001）。在本研究患者中，NT-proBNP联合LVEF预测心脏毒性的曲线下面积（AUC）为0.898（95%可信区间：0.829-0.966）。
NT-proBNP联合超声心动图在蒽环类药物所致心脏毒性检测中具有临床意义，可检测蒽环类药物所致早期心肌损伤，具有早期预测价值。对保护心脏功能及判断预后具有重要意义。
