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二维斑点追踪成像在蒽环类药物治疗乳腺癌所致心脏毒性中的应用

Two-dimensional Speckle Tracking Imaging in Cardiotoxicity Caused by Treatment of Breast Carcinoma with Anthracyclines.

作者信息

Song Wenjuan, Ma Xuejuan, Sun Yue, Liu Liping, Gu Ying, Zhao Yue, Ye Yujia, Wang Yu

机构信息

Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, China.

出版信息

J Cancer. 2024 Sep 9;15(17):5710-5718. doi: 10.7150/jca.98204. eCollection 2024.

Abstract

This research was conducted to investigate the monitoring values of routine echocardiography (ECG) and two-dimensional speckle tracking imaging (2D-STI) in cardiotoxicity caused by the treatment of breast carcinoma with anthracyclines (ANTH). 100 patients with breast carcinoma were selected and enrolled into normal group (n=53 cases) and abnormal group (47 cases) according to whether ECG was abnormal. Routine ECG and 2D-STI were employed for the detection, ECG- and 2D-STI-related parameters were compared, receiver operating characteristic (ROC) curves were drawn, and the clinical application values of monitoring methods for two groups were assessed. Before chemotherapy, no remarkable statistical difference was detected in routine ECG and 2D-STI parameters between normal and abnormal groups (>0.05). After 6 cycles, E/V value of abnormal group was inferior to that of normal group ((0.93±0.16) vs (1.33±0.23). Besides, longitudinal peak strain (SRI) values of rear wall, front spacer, and rear spacer in abnormal group were inferior to those in normal group (<0.05). Routine ECG combined with 2D-STI had the best predictive effect followed by 2D-STI and routine ECG. To sum up, 2D-STI was a new method for assessing myocardial lesions and possessed significant early clinical monitoring values in cardiotoxicity caused by chemotherapy after the treatment of breast carcinoma with ANTH. It had higher clinical application values than routine ECG.

摘要

本研究旨在探讨常规超声心动图(ECG)和二维斑点追踪成像(2D-STI)在蒽环类药物(ANTH)治疗乳腺癌所致心脏毒性中的监测价值。选取100例乳腺癌患者,根据心电图是否异常分为正常组(n = 53例)和异常组(47例)。采用常规心电图和2D-STI进行检测,比较心电图和2D-STI相关参数,绘制受试者工作特征(ROC)曲线,评估两组监测方法的临床应用价值。化疗前,正常组和异常组的常规心电图和2D-STI参数无显著统计学差异(>0.05)。6个周期后,异常组的E/V值低于正常组((0.93±0.16)对(1.33±0.23))。此外,异常组后壁、前间隔和后间隔的纵向峰值应变(SRI)值低于正常组(<0.05)。常规心电图联合2D-STI的预测效果最佳,其次是2D-STI和常规心电图。综上所述,2D-STI是评估心肌损伤的一种新方法,在ANTH治疗乳腺癌后化疗所致心脏毒性中具有重要的早期临床监测价值。其临床应用价值高于常规心电图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f21/11414615/662097e210bc/jcav15p5710g001.jpg

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