Sobić-Saranović D, Pavlović S, Susnjar S, Neskovi c-Konstantinović Z, Jelić S
Institute of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Yugoslavia.
Anticancer Res. 1997 Sep-Oct;17(5B):3889-91.
Anthracycline-containing chemotherapy has been the most frequently observed cause of iatrogenic cardiac damage in patients with breast cancer. The purpose of this study was to evaluate by radionuclide ventriculography whether a mean cumulative dose of epirubicin (MCDE) induced left ventricular (LV) systolic or/and diastolic dysfunction in 32 patients treated for breast cancer.
Thirty-two patients with breast cancer according to chemotherapeutical trials received MCDE of 360 m/m2. All patients were studied before and after they completed chemotherapy with radionuclide ventriculography at rest. Systolic and diastolic left ventricular parameters were assessed.
Diastolic left ventricular parameters and R-R intervals significantly differed before and after completed chemotherapy in our patients: peak filling rate (PFR: 2.8 +/- 0.6 vs. 2.2 +/- 0.7 EDV/sec) and time to filling rate (TPFR: 182 +/- 48 vs. 2.25 +/- 50 msec), R-R: 723 +/- 51 vs. 620 +/- 45 msec, p < 0.01. Ejection fraction, as a systolic parameter/did not significantly differ before and after completed chemotherapy (EF: 59 +/- 7 vs. 58 +/- 6%), p > 0.05.
Our results indicate that left ventricular diastolic dysfunction even at an MCDE of 360 mg/m2 may be an early sign of epirubicin cardiotoxicity.
含蒽环类药物的化疗一直是乳腺癌患者医源性心脏损伤最常见的原因。本研究的目的是通过放射性核素心室造影评估在32例接受乳腺癌治疗的患者中，表柔比星的平均累积剂量（MCDE）是否会诱发左心室（LV）收缩或/和舒张功能障碍。
根据化疗试验，32例乳腺癌患者接受了360 m/m2的MCDE。所有患者在完成化疗前后均接受静息状态下的放射性核素心室造影检查。评估左心室收缩和舒张参数。
在我们的患者中，完成化疗前后舒张期左心室参数和R-R间期有显著差异：峰值充盈率（PFR：2.8±0.6 vs. 2.2±0.7 EDV/秒）和达到充盈率的时间（TPFR：182±48 vs. 225±50毫秒），R-R：723±51 vs. 620±45毫秒，p<0.01。射血分数作为收缩期参数，在完成化疗前后无显著差异（EF：59±7 vs. 58±6%），p>0.05。
我们的结果表明，即使在MCDE为360 mg/m2时，左心室舒张功能障碍也可能是表柔比星心脏毒性的早期迹象。
