Piñeiro-Lamas Beatriz, López-Cheda Ana, Cao Ricardo, Lesta-Mellid Rocío, Bouzas-Mosquera Alberto, Barbeito-Caamaño Cayetana
Grupo de Modelización, Optimización e Inferencia Estatística, Departamento de Matemáticas, Facultade de Informática, Universidade da Coruña, CITIC, Campus de Elviña, 15071, A Coruña, Spain.
Servicio de Oncología, Complexo Hospitalario Universitario de A Coruña, 15006, A Coruña, Spain.
Int J Cardiovasc Imaging. 2025 Jun 23. doi: 10.1007/s10554-025-03439-1.
Although early detection and prediction of cancer therapy-related cardiac dysfunction (CTRCD) have been widely studied in the literature in breast cancer patients, little is known about the potential predictive role of Tissue Doppler Imaging (TDI) as a risk factor. The purpose of this study is to assess the predictive role of Pulsed-waved TDI in predicting cardiotoxicity in breast cancer patients. In total, 270 breast cancer patients, 27 of whom experienced CTRCD during the follow-up period, were enrolled. Echocardiography was performed at baseline (before the beginning of the treatment), and TDI images were obtained. Other clinical variables were also measured. Significant differences were found between the TDI images of patients who developed cardiotoxicity and those of patients who did not, particularly around the [Formula: see text] wave. Specifically, patients with CTRCD had a smoother and later [Formula: see text] wave. The variable [Formula: see text], which accounts for both the peak velocity of the [Formula: see text] wave and the timing within the cardiac cycle when this peak is reached, was found to be highly informative. Patients with a [Formula: see text] value above the threshold of 0.052 have a higher risk of CTRCD, which supports its potential as an early indicator of the risk of cardiotoxicity. The [Formula: see text] in the baseline TDI is significantly associated with the CTRCD. Specific characteristics of the [Formula: see text] wave, such as the moment in the cycle when its peak occurs and its velocity, may be used in clinical practice to predict cardiovascular side effects in patients undergoing breast cancer treatment.
尽管在乳腺癌患者中，癌症治疗相关心脏功能障碍（CTRCD）的早期检测和预测在文献中已有广泛研究，但关于组织多普勒成像（TDI）作为危险因素的潜在预测作用却知之甚少。本研究的目的是评估脉冲波TDI在预测乳腺癌患者心脏毒性方面的作用。总共招募了270例乳腺癌患者，其中27例在随访期间出现了CTRCD。在基线（治疗开始前）进行超声心动图检查，并获取TDI图像。还测量了其他临床变量。在发生心脏毒性的患者和未发生心脏毒性的患者的TDI图像之间发现了显著差异，特别是在[公式：见正文]波周围。具体而言，患有CTRCD的患者的[公式：见正文]波更平滑且出现时间更晚。发现变量[公式：见正文]，它既考虑了[公式：见正文]波的峰值速度，又考虑了达到该峰值时心动周期内的时间，具有很高的信息量。[公式：见正文]值高于0.052阈值的患者发生CTRCD的风险更高，这支持了其作为心脏毒性风险早期指标的潜力。基线TDI中的[公式：见正文]与CTRCD显著相关。[公式：见正文]波的特定特征，如峰值出现时的心动周期时刻及其速度，可在临床实践中用于预测接受乳腺癌治疗患者的心血管副作用。
