Shen Hesong, Xu Qian, Tu Chunrong, Peng Yangling, Xie Yuhang, Miao Zhiming, Yang Rui, Zhang Jiuquan
Department of Radiology Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital Chongqing China.
School of Medicine Chongqing University Chongqing China.
MedComm (2020). 2025 Jan 2;6(1):e70004. doi: 10.1002/mco2.70004. eCollection 2025 Jan.
The left ventricular trabecular fractal dimension (LVTFD) derived from cardiac magnetic resonance reflects myocardial trabecular complexity, which is associated with cardiovascular disease risk. Baseline risk stratification of cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer who received anthracycline is a very important clinical issue. In this study, we used the Cox model to derive and validate a new score system based on LVTFD for baseline risk stratification of CTRCD in breast cancer patients receiving anthracycline. We also compare the performance of LVTFD-based score with the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) score using C-index. This study enrolled 370 participants, of whom 73 participants developed CTRCD. The C-indices of LVTFD-based score integrating age, hypertension, previous cardiovascular disease, and maximal apical fractal dimension were higher than those of HFA-ICOS score for stratifying CTRCD (0.834 vs. 0.642 and 0.834 vs. 0.633, respectively, in derivation and validation cohort). LVTFD-based score can stratify the CTRCD risk, but HFA-ICOS score cannot. The above results reveal that the LVTFD-based score is an alternative method for baseline risk stratification of CTRCD in breast cancer who received anthracycline.
源自心脏磁共振成像的左心室小梁分形维数（LVTFD）反映了心肌小梁的复杂性，而这与心血管疾病风险相关。对于接受蒽环类药物治疗的乳腺癌患者，癌症治疗相关心脏功能障碍（CTRCD）的基线风险分层是一个非常重要的临床问题。在本研究中，我们使用Cox模型来推导并验证一种基于LVTFD的新评分系统，用于接受蒽环类药物治疗的乳腺癌患者CTRCD的基线风险分层。我们还使用C指数比较了基于LVTFD的评分与心力衰竭协会-国际心脏肿瘤学会（HFA-ICOS）评分的性能。本研究纳入了370名参与者，其中73名参与者发生了CTRCD。整合年龄、高血压、既往心血管疾病和最大心尖分形维数的基于LVTFD的评分在CTRCD分层中的C指数高于HFA-ICOS评分（在推导队列和验证队列中分别为0.834对0.642和0.834对0.633）。基于LVTFD的评分可以对CTRCD风险进行分层，但HFA-ICOS评分则不能。上述结果表明，基于LVTFD的评分是接受蒽环类药物治疗的乳腺癌患者CTRCD基线风险分层的一种替代方法。
