Huang Junzhe, Lei Changhui, Hsi David H, Zheng Minjuan, Ma Hui, Ta Shengjun, Hu Rui, Han Chao, Li Wenxia, Li Jing, Qu Dong, Ruan Fangqi, Wang Jing, Wang Bo, Zhao Xueli, Liu Jiao, Zhao Lina, Wang Zhe, Yang Jian, Liu Liwen
Xijing Ultrasound Interventional Treatment Center for Cancer, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Heart & Vascular Institute, Stamford Hospital, Connecticut, USA.
JACC CardioOncol. 2024 Apr 30;6(4):560-571. doi: 10.1016/j.jaccao.2024.03.008. eCollection 2024 Aug.
Patients with cardiac tumors may present challenges for surgical resection due to poor clinical condition. Echocardiography-guided transapical radiofrequency ablation for cardiac tumors (TARFACT) potentially offers a less invasive palliative therapy option.
This study aimed to evaluate the safety and efficacy of TARFACT.
Five patients with cardiac tumors (mucinous liposarcoma, myocardial hypertrophy with inflammatory cell infiltration mass, fibrous tissue tumor hyperplasia, myocardial clear cell sarcoma, and cardiac rhabdomyoma) were included. All patients underwent TARFACT and were assessed with electrocardiogram, echocardiographic imaging, biochemical analysis, and pathological confirmation.
The median follow-up for all patients was 9 (range 4-12) months. Three surviving patients were alive at their last follow-up (9, 12, and 12 months, respectively), whereas 2 patients with late-stage tumors survived 6 months and 13 months after TARFACT, respectively. After TARFACT, all patients showed significant reductions in tumor size: the mean length decreased from 6.7 ± 2.0 cm to 4.7 ± 1.8 cm ( = 0.007); and the mean width decreased from 5.0 ± 2.1 cm to 2.5 ± 0.7 cm ( = 0.041). NYHA functional class also improved: median (IQR) decreased from 3.0 (1.5) to 2.0 (1.0) ( = 0.038), Peak E-wave on echocardiography showed a mean increase from 64.4 ± 15.7 cm/s to 76.6 ± 18.6 cm/s ( = 0.008), and NT-pro BNP levels had a median (IQR) reduction from 115.7 (252.1) pg/mL to 55.0 (121.6) pg/mL ( = 0.043).
TARFACT is a novel palliative treatment option for cardiac tumors, reducing accessible tumors and improving clinical symptoms in a preliminary group of patients. (Cardiac Tumors Interventional [Radio Frequency/Laser Ablation] Therapy [CTIH]; NCT02815553).
由于临床状况不佳，心脏肿瘤患者的手术切除可能面临挑战。超声心动图引导下经心尖心脏肿瘤射频消融术（TARFACT）可能提供一种侵入性较小的姑息治疗选择。
本研究旨在评估TARFACT的安全性和有效性。
纳入5例心脏肿瘤患者（黏液性脂肪肉瘤、伴有炎性细胞浸润肿块的心肌肥厚、纤维组织肿瘤增生、心肌透明细胞肉瘤和心脏横纹肌瘤）。所有患者均接受TARFACT治疗，并通过心电图、超声心动图成像、生化分析和病理确诊进行评估。
所有患者的中位随访时间为9个月（范围4 - 12个月）。3例存活患者在最后一次随访时仍存活（分别为9个月、12个月和12个月），而2例晚期肿瘤患者在TARFACT后分别存活6个月和13个月。TARFACT后，所有患者的肿瘤大小均显著减小：平均长度从6.7±2.0 cm降至4.7±1.8 cm（P = 0.007）；平均宽度从5.0±2.1 cm降至2.5±0.7 cm（P = 0.041）。纽约心脏协会（NYHA）心功能分级也有所改善：中位数（四分位间距）从3.0（1.5）降至2.0（1.0）（P = 0.038），超声心动图上的E峰速度平均从64.4±15.7 cm/s增至76.6±18.6 cm/s（P = 0.008），N末端B型利钠肽原（NT-pro BNP）水平中位数（四分位间距）从115.7（252.1）pg/mL降至55.0（121.6）pg/mL（P = 0.043）。
TARFACT是一种用于心脏肿瘤的新型姑息治疗选择，在一组初步患者中可缩小可触及肿瘤并改善临床症状。（心脏肿瘤介入[射频/激光消融]治疗[CTIH]；NCT02815553）
