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日本乳腺癌患者接受蒽环类化疗后的亚临床心肌损伤。

Subclinical myocardial damage after anthracycline chemotherapy in Japanese patients with breast cancer.

机构信息

Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.

Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

J Cardiol. 2024 Oct;84(4):260-265. doi: 10.1016/j.jjcc.2024.03.005. Epub 2024 Mar 22.

Abstract

BACKGROUND

Data on the incidence, timing, and severity of myocardial damage after anthracycline-based chemotherapy (AC) in Japanese patients with breast cancer are limited.

METHOD

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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