Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Cardiol. 2024 Oct;84(4):260-265. doi: 10.1016/j.jjcc.2024.03.005. Epub 2024 Mar 22.
Data on the incidence, timing, and severity of myocardial damage after anthracycline-based chemotherapy (AC) in Japanese patients with breast cancer are limited.
We evaluated cancer therapy-related cardiac dysfunction (CTRCD) in Japanese women with breast cancer (n = 51) after the first AC according to the definitions of the 2022 European Society of Cardiology onco-cardiology guideline, including assessment of high-sensitivity troponin I (TnI) and B-type natriuretic peptide (BNP) levels.
CTRCD was detected in 67 % of the patients (3.9 %, 7.8 %, 9.8 %, 43 %, 37 %, 22 %, 20 %, and 9.8 % of patients at 1 week and 1, 2, 3, 6, 9, 12, and 15 months post-AC, respectively) without significant left ventricular ejection fraction reduction (<50 %) and heart failure. Elevated TnI levels (>26 pg/mL) were found in 43 % of patients, and elevated BNP levels (≥35 pg/mL) were observed in 22 % of patients during the follow-up period.
Approximately two-thirds of the Japanese patients in this study experienced CTRCD, which was frequently observed at 3 or 6 months post-AC. However, all patients with CTRCD were diagnosed with mild asymptomatic CTRCD. Although, these patients were diagnosed with mild asymptomatic CTRCD, careful long-term follow-up will be required.
关于蒽环类药物化疗(AC)后日本乳腺癌患者心肌损伤的发生率、时间和严重程度的数据有限。
我们根据 2022 年欧洲心脏病学会肿瘤心脏病学指南的定义,评估了 51 例日本乳腺癌女性患者在首次 AC 后的癌症治疗相关心功能障碍(CTRCD),包括高敏肌钙蛋白 I(TnI)和 B 型利钠肽(BNP)水平的评估。
67%的患者检测到 CTRCD(分别为 1 周和 1、2、3、6、9、12 和 15 个月时的 3.9%、7.8%、9.8%、43%、37%、22%和 20%),无明显左心室射血分数降低(<50%)和心力衰竭。43%的患者 TnI 水平升高(>26pg/mL),22%的患者 BNP 水平升高(≥35pg/mL)。
在这项研究中,大约三分之二的日本患者出现 CTRCD,这种情况在 AC 后 3 或 6 个月经常发生。然而,所有患有 CTRCD 的患者均被诊断为轻度无症状的 CTRCD。尽管这些患者被诊断为轻度无症状的 CTRCD,但需要进行仔细的长期随访。