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实体肿瘤患者接受阿霉素治疗时左心室收缩和充盈异常(作者译)

[Abnormal left-ventricular contraction and filling in patients receiving adriamycin for solid tumours (author's transl)].

作者信息

Stein E, Hanrath P, Bleifeld W, Garbrecht M, Müllerleile U

出版信息

Dtsch Med Wochenschr. 1978 Sep 8;103(36):1408-12. doi: 10.1055/s-0028-1129273.

Abstract

Various ventricular functions, as obtained by echocardiography (M-mode), were measured on 14 patients with solid tumours receiving adriamycin (mean total dosage 330 +/- 188 mg/m2 body surface area), the results being compared with those on 14 normal subjects of similar ages. There were statistically highly significant differences between the two groups. In those receiving the drug there was (1) a decrease in the percentage shortening fraction and (2) a reduction in the maximal velocity of endocardial circumferential fibre shortening, as expression of reduced contractility. The abnormal filling was characterized by a marked decrease in maximal velocity of endocardial fibre stretch, diminution of diameter increase during the rapid filling phase, and a shortened duration of the rapid filling phase. There was no electrocardiographic or radiological evidence of myocardial damage. The findings suggest that it will be possible by serial echocardiography to recognize a higher tolerance to the drug in some individuals and, at the same time, reveal abnormal contractility and filling due to adriamycin before irreversible heart failure has occurred.

摘要

对14例接受阿霉素治疗(平均总剂量330±188mg/m²体表面积)的实体瘤患者,通过超声心动图(M型)测量了各种心室功能,并将结果与14例年龄相仿的正常受试者进行了比较。两组之间存在统计学上的高度显著差异。接受该药物治疗的患者出现了:(1)缩短分数百分比降低;(2)心内膜圆周纤维缩短最大速度降低,这是收缩力降低的表现。异常充盈的特征是心内膜纤维伸展最大速度显著降低、快速充盈期直径增加减小以及快速充盈期持续时间缩短。没有心电图或放射学证据表明存在心肌损伤。这些发现表明,通过系列超声心动图有可能识别出一些个体对该药物具有更高的耐受性,同时在不可逆心力衰竭发生之前揭示出由阿霉素引起的异常收缩力和充盈情况。

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