Liu Jian, Guan Weizheng, Sun Yilin, Wang Yuling, Li Guangqiao, Zhang Sai, Shi Bo
Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, China.
School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China.
Front Physiol. 2023 Feb 28;14:1126057. doi: 10.3389/fphys.2023.1126057. eCollection 2023.
Previous studies have shown that heart rate variability (HRV) analysis is a sensitive indicator of chemotherapy-induced cardiotoxicity. However, most studies to date have observed long-term effects using long-term analyses. The main purpose of this study was to evaluate the acute effect of chemotherapy on the cardiac autonomic nervous system (ANS) in patients with cervical cancer (CC) by examining short-term HRV. Fifty patients with CC admitted to the Department of Gynecology and Oncology of the First Affiliated Hospital of Bengbu Medical College were enrolled in the study. Based on their chemotherapy regimens, the patients were divided into a DC group (docetaxel + carboplatin) and a TC group (paclitaxel + carboplatin). A 5-min resting electrocardiogram (ECG) was collected before and the day after chemotherapy: the time domain (standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD)) and frequency domain (low-frequency power (LF), high-frequency power (HF), and (LF/HF)) parameters were analyzed, and the differences before and after chemotherapy were compared. The results showed that SDNN, RMSSD and HF were significantly higher in the DC and TC groups after chemotherapy than before ( < 0.05, Cohen's > 0.5). In addition, LF was significantly higher after TC than before chemotherapy ( < 0.05, Cohen's > 0.3), and LF/HF was significantly lower after DC than before chemotherapy ( < 0.05, Cohen's > 0.5). Chemotherapy combining taxane and carboplatin can increase the HRV of CC patients in the short term, and HRV may be a sensitive tool for the early detection of chemotherapy-induced cardiac ANS perturbations.
以往研究表明,心率变异性(HRV)分析是化疗所致心脏毒性的敏感指标。然而,迄今为止,大多数研究都是通过长期分析来观察长期影响。本研究的主要目的是通过检测短期HRV来评估化疗对宫颈癌(CC)患者心脏自主神经系统(ANS)的急性影响。蚌埠医学院第一附属医院妇科肿瘤科收治的50例CC患者纳入本研究。根据化疗方案,将患者分为多西他赛+卡铂组(DC组)和紫杉醇+卡铂组(TC组)。在化疗前及化疗后当天采集5分钟静息心电图(ECG):分析时域(正常RR间期标准差(SDNN)和连续差值均方根(RMSSD))和频域(低频功率(LF)、高频功率(HF)及LF/HF)参数,并比较化疗前后的差异。结果显示,DC组和TC组化疗后SDNN、RMSSD和HF均显著高于化疗前(P<0.05,Cohen's d>0.5)。此外,TC组化疗后LF显著高于化疗前(P<0.05,Cohen's d>0.3),DC组化疗后LF/HF显著低于化疗前(P<0.05,Cohen's d>0.5)。紫杉烷与卡铂联合化疗可在短期内增加CC患者的HRV,且HRV可能是早期检测化疗所致心脏ANS紊乱的敏感工具。