Department of Ultrasound Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China.
Department of Ultrasound Medicine, Jiangxi Cancer Hospital, Nanchang 330029, China.
Curr Med Imaging. 2024;20:e15734056298648. doi: 10.2174/0115734056298648240604072237.
Patients with diffuse large B-cell lymphoma (DLBCL) often experience a poor prognosis due to cardiac damage induced by anthracycline chemotherapy, with left ventricular diastolic dysfunction manifesting early. Vector Flow Mapping (VFM) is a novel technology, and its effectiveness in detecting left ventricular diastolic dysfunction following anthracycline chemotherapy remains unverified.
This study evaluates left ventricular diastolic function in DLBCL patients after anthracycline chemotherapy using vector flow mapping (VFM).
We prospectively enrolled 54 DLBCL patients who had undergone anthracycline chemotherapy (receiving a minimum of 4 cycles) as the case group and 54 age- and sex-matched individuals as controls. VFM assessments were conducted in the case group pre-chemotherapy (T0), post-4 chemotherapy cycles (T4), and in the control group. Measurements included basal, middle, and apical segment energy loss (ELb, ELm, ELa) and intraventricular pressure differences (IVPDb, IVPDm, IVPDa) across four diastolic phases: isovolumic relaxation (D1), rapid filling (D2), slow filling (D3), and atrial contraction (D4).
When comparing parameters between the control and case groups at T0, no significant differences were observed in general data, conventional ultrasound parameters, and VFM parameters (all P > 0.05). From T0 to T4, ELa significantly increased throughout the diastole cycle (all P < 0.05); ELm increased only during D4 (all P < 0.05); and ELb increased during D1, D2, and D4 (all P < 0.05). All IVPD measurements (IVPDa, IVPDm, IVPDb) increased during D1 and D4 (all P < 0.05) but decreased during D2 and D3 (all P < 0.05). Significant positive correlations were identified between ELa-D4, IVPDa-D4, and parameters A, e', E/e,' and LAVI (all r > 0.5, all P < 0.001). Negative correlations were noted with E/A for ELa- D4 IVPDa-D4 (all r < -0.5, all P < 0.001). Positive correlations were observed for IVPDa-D1, IVPDa-D2 with E, E/e', and LAVI (0.3<r<0.5, all P<0.001).
VFM parameters demonstrate a certain correlation with conventional diastolic function parameters and show promise in assessing left ventricular diastolic function. Furthermore, VFM parameters exhibit greater sensitivity to early diastolic function changes, suggesting that VFM could be a novel method for evaluating differences in left ventricular diastolic function in DLBCL patients before and after chemotherapy.
由于蒽环类化疗引起的心脏损伤，弥漫性大 B 细胞淋巴瘤（DLBCL）患者的预后通常较差，左心室舒张功能障碍表现较早。向量流图（VFM）是一种新的技术，其在检测蒽环类化疗后左心室舒张功能中的有效性尚未得到验证。
本研究使用向量流图（VFM）评估 DLBCL 患者蒽环类化疗后的左心室舒张功能。
我们前瞻性地招募了 54 例接受蒽环类化疗（至少接受 4 个周期）的 DLBCL 患者作为病例组，同时招募了 54 名年龄和性别匹配的个体作为对照组。在病例组化疗前（T0）、化疗后 4 个周期（T4）和对照组进行 VFM 评估。测量包括舒张期四个阶段（等容松弛期[D1]、快速充盈期[D2]、缓慢充盈期[D3]和心房收缩期[D4]）的基底部、中部和心尖段能量损失（ELb、ELm、ELa）和心室内压差异（IVPDb、IVPDm、IVPDa）。
在 T0 时，将对照组和病例组的参数进行比较，一般数据、常规超声参数和 VFM 参数均无显著差异（均 P > 0.05）。从 T0 到 T4，ELa 在整个舒张周期均显著增加（均 P < 0.05）；ELm 仅在 D4 期间增加（均 P < 0.05）；ELb 在 D1、D2 和 D4 期间增加（均 P < 0.05）。所有 IVPD 测量值（IVPDa、IVPDm、IVPDb）在 D1 和 D4 期间增加（均 P < 0.05），但在 D2 和 D3 期间减少（均 P < 0.05）。ELa-D4、IVPDa-D4 与参数 A、e'、E/e'和 LAVI 之间存在显著正相关（均 r > 0.5，均 P < 0.001）。ELa-D4、IVPDa-D4 与 E/A 呈负相关（均 r < -0.5，均 P < 0.001）。IVPDa-D1 和 IVPDa-D2 与 E、E/e'和 LAVI 呈正相关（0.3<r<0.5，均 P<0.001）。
VFM 参数与常规舒张功能参数具有一定相关性，有望用于评估左心室舒张功能。此外，VFM 参数对早期舒张功能变化具有更高的敏感性，表明 VFM 可能是评估 DLBCL 患者化疗前后左心室舒张功能差异的一种新方法。
