Liang Yan, Du Ping, Song Yabo, Li Xinshi, Han Yingying, Dongye Hongfang, Liu Hongqiang, Li Jinqiu
Department of Ultrasound Medicine, Zhangjiakou First Hospital, Zhangjiakou, 075000, China.
Department of Imaging, Zhangjiakou First Hospital, Zhangjiakou, 075000, China.
Sci Rep. 2025 Jan 22;15(1):2765. doi: 10.1038/s41598-025-87272-5.
To research the value of Autostrain right ventricular (RV) technology in detecting and preventing right ventricular myocardial injury in patients undergoing breast cancer chemotherapy by providing an imaging basis for early identification. To examine the changes in various cardiac function parameters before and after chemotherapy, two-dimensional echocardiography was employed 48 h before chemotherapy, 48 h after the fourth cycle of chemotherapy, and 48 h after the eighth cycle of chemotherapy, respectively. The patients included those with breast cancer who underwent surgery and were primarily administered anthracycline-based chemotherapeutic drugs. (1) Compared with the pre-chemotherapy period, the absolute values of the right ventricular global longitudinal strain (RV4CSL) and right ventricular free-wall longitudinal strain (RVFWSL) decreased after the fourth chemotherapy cycle, and no significant differences were observed in tricuspidannular plane systolic excursion (TAPSE), right ventricular Tei index, and right ventricular fractional area change (FAC); (2) Compared with the pre-chemotherapy period, the absolute values of RV4CSL and RVFWSL decreased after the eighth chemotherapy cycle. TAPSE and FAC decreased, the right ventricular Tei index increased; (3) Compared with the end of the fourth chemotherapy cycle, the absolute values of RV4CSL and RVFWSL decreased at the end of the eighth chemotherapy cycle. TAPSE, right ventricular Tei index and FAC were not significantly different. (4) Pearson correlation analysis revealed a correlation between the absolute value of RV4CSL, the absolute value of RVFWSL, right ventricular Tei index, TAPSE and FAC. The absolute values of RV4CSL and RVFWSL are sensitive indices that reflect changes in the right ventricular myocardium in the early stages of chemotherapy. They can reflect the effects of anthracycline on the right ventricular myocardium of patients with breast cancer earlier than the TAPSE, FAC and right ventricular Tei indices. A relationship exists between the absolute value of RVFWSL, the absolute value of RV4CSL, right ventricular Tei index, TAPSE, FAC and anthracycline-induced alterations in the right ventricular myocardium. This study is helpful for early detection of right ventricular myocardial function injury caused by anthracyclines in breast cancer patients, and provides imaging basis for early clinical detection and prevention of right ventricular myocardial injury.
为研究自动应变右心室（RV）技术在乳腺癌化疗患者右心室心肌损伤检测及预防中的价值，为早期识别提供影像学依据。为观察化疗前后各项心功能参数的变化，分别于化疗前48小时、化疗第4周期后48小时及化疗第8周期后48小时采用二维超声心动图检查。患者为接受手术治疗且主要使用蒽环类化疗药物的乳腺癌患者。（1）与化疗前相比，化疗第4周期后右心室整体纵向应变（RV4CSL）和右心室游离壁纵向应变（RVFWSL）绝对值降低，三尖瓣环平面收缩期位移（TAPSE）、右心室Tei指数及右心室面积变化分数（FAC）差异无统计学意义；（2）与化疗前相比，化疗第8周期后RV4CSL和RVFWSL绝对值降低，TAPSE及FAC降低，右心室Tei指数升高；（3）与化疗第4周期末相比，化疗第8周期末RV4CSL和RVFWSL绝对值降低，TAPSE、右心室Tei指数及FAC差异无统计学意义；（4）Pearson相关性分析显示，RV4CSL绝对值、RVFWSL绝对值、右心室Tei指数、TAPSE及FAC之间存在相关性。RV4CSL和RVFWSL绝对值是反映化疗早期右心室心肌变化的敏感指标，比TAPSE、FAC及右心室Tei指数能更早反映蒽环类药物对乳腺癌患者右心室心肌的影响。RVFWSL绝对值、RV4CSL绝对值、右心室Tei指数、TAPSE、FAC与蒽环类药物所致右心室心肌改变之间存在关联。本研究有助于早期发现乳腺癌患者蒽环类药物所致右心室心肌功能损伤，为临床早期检测及预防右心室心肌损伤提供影像学依据。
