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评估接受心脏毒性化疗药物治疗的患者的左房机电延迟和左房时相功能。

Evaluation of Left Atrial Electromechanical Delay and Left Atrial Phasic Functions in Patients Undergoing Treatment with Cardiotoxic Chemotherapeutic Agents.

机构信息

Department of Cardiology, Amasya University, Sabuncuoğlu Şerefeddin Training and Research Hospital, 05100 Amasya, Turkey.

Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, 55270 Samsun, Turkey.

出版信息

Medicina (Kaunas). 2024 Sep 18;60(9):1516. doi: 10.3390/medicina60091516.

Abstract

The aim of this study is to evaluate atrial involvement by comparing pre- and post-chemotherapy left atrial mechanical and electromechanical parameters in patients treated with cardiotoxic chemotherapeutic agents. We designed our study as a prospective cohort study. Sixty-eight female patients between the ages of 18 and 50, scheduled for treatment with cardiotoxic chemotherapeutic agents, were included in our study. Atrial mechanical functions and electromechanical parameters were examined and compared with basic echocardiographic parameters before and after chemotherapy. The mean age of the patients was 41.6 ± 7.9 years. After chemotherapy, lateral PA, septal PA, and tricuspid PA durations showed a significant increase ( < 0.001), but there were no statistically significant changes in the left intra-atrial electromechanical delay, the right intra-atrial electromechanical delay, or the interatrial electromechanical delay values. Following treatment, LAVmax, LAVmin, and LApreA significantly increased ( < 0.001). Additionally, the left atrial passive and active emptying volumes increased ( < 0.001), while the reservoir and pump (active emptying) functions decreased (with -values of 0.03 and 0.01, respectively). The passive emptying function, however, showed no significant change ( = 0.65). Decreases in LVEF were observed, while LVEDD, LVESD, IVS, PW, and LA diameters increased (-value of 0.02 for IVS and <0.001 for the others). Significant impairment of atrial mechanical functions and electromechanical parameters was observed after treatment with cardiotoxic chemotherapeutic agents. This suggests an elevated likelihood of atrial arrhythmia linked to the use of cardiotoxic chemotherapeutic agents.

摘要

本研究旨在通过比较接受心脏毒性化疗药物治疗的患者化疗前后左房机械和机电参数,评估心房受累情况。我们设计了前瞻性队列研究。纳入 68 名年龄在 18 岁至 50 岁之间、计划接受心脏毒性化疗药物治疗的女性患者。在化疗前后检查心房机械功能和机电参数,并与基本超声心动图参数进行比较。患者的平均年龄为 41.6±7.9 岁。化疗后,侧壁 PA、间隔 PA 和三尖瓣 PA 持续时间显著增加(<0.001),但左房内机电延迟、右房内机电延迟或房间隔机电延迟值无统计学意义变化。治疗后,LAVmax、LAVmin 和 LApreA 显著增加(<0.001)。此外,左房被动排空和主动排空容积增加(<0.001),而储存和泵(主动排空)功能下降(-值分别为 0.03 和 0.01)。然而,被动排空功能没有显著变化(=0.65)。观察到 LVEF 下降,而 LVEDD、LVESD、IVS、PW 和 LA 直径增加(IVS 的-值为 0.02,其他均<0.001)。心脏毒性化疗药物治疗后观察到心房机械功能和机电参数明显受损。这提示心脏毒性化疗药物的使用可能导致心房心律失常的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1317/11434181/074add98b898/medicina-60-01516-g001.jpg

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