Wang Zi-Ying, Huang Long, Li Li-Qun, Zhang Chun-Quan, Guo Liang-Yun, Liu Yan-Na, Liao Ling-Min
Department of Ultrasound, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Department of Oncology, The Second Affifiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
BMC Cardiovasc Disord. 2025 Mar 20;25(1):199. doi: 10.1186/s12872-025-04636-5.
This study aimed to detect early changes in left ventricular systolic function in Beagle dogs after radiotherapy using two-dimensional speckle tracking echocardiography and to explore its potential value in evaluating radiation-induced heart disease.
Thirty-six Beagle dogs were randomized into a control group (n = 18) and an irradiation group (n = 18). The irradiation group received a single dose of 20 Gy to the left ventricular anterior wall, while controls underwent sham irradiation. Conventional echocardiography and 2D speckle tracking echocardiography were performed at baseline and 3, 6, and 12 months post-procedure. Additionally, six dogs were randomly selected from each group and euthanized at 3-, 6-, and 12-month post-irradiation, and their hearts were collected for histopathological testing.
In the irradiation group, the global longitudinal strain of the left ventricle and regional strain in the irradiated area were significantly reduced versus baseline and controls by 3 months, with progressive decline at 6 and 12 months. Strain reduction correlated spatially with pathological injury. Conversely, there were no substantial differences in conventional echocardiographic parameters between the groups after 3 months. Conventional parameters (e.g., LVEF) showed differences only at later timepoints. Histopathology revealed progressive cardiomyocyte damage, fibrosis, and microvascular injury in irradiated regions, extending to the posterior wall by 12 months.
Two-dimensional speckle tracking echocardiography-derived strain parameters spatially correlate with radiation-induced pathological changes and detect subtle systolic dysfunction prior to irreversible remodeling. Speckle tracking may localize regions of peak radiation dose delivery.
本研究旨在使用二维斑点追踪超声心动图检测比格犬放疗后左心室收缩功能的早期变化,并探讨其在评估放射性心脏病中的潜在价值。
36只比格犬随机分为对照组(n = 18)和照射组(n = 18)。照射组接受单次20 Gy的左心室前壁照射,而对照组接受假照射。在基线以及术后3、6和12个月进行常规超声心动图和二维斑点追踪超声心动图检查。此外,每组随机选取6只犬在照射后3、6和12个月实施安乐死,并采集心脏进行组织病理学检查。
在照射组中,左心室整体纵向应变以及照射区域的局部应变在3个月时相对于基线和对照组显著降低,在6个月和12个月时逐渐下降。应变降低在空间上与病理损伤相关。相反,3个月后两组之间的常规超声心动图参数没有实质性差异。常规参数(如左心室射血分数)仅在后期时间点出现差异。组织病理学显示照射区域存在进行性心肌细胞损伤、纤维化和微血管损伤,到12个月时扩展至后壁。
二维斑点追踪超声心动图得出的应变参数在空间上与辐射诱导的病理变化相关,并能在不可逆重塑之前检测到细微的收缩功能障碍。斑点追踪可定位辐射剂量递送峰值区域。