Early Detection of Epirubicin-Induced Cardiotoxicity in Patients with Breast Cancer
Early Detection of Epirubicin-Induced Cardiotoxicity in Patients with Breast Cancer
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DOI：
10.1016/j.echo.2013.10.008
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发表时间：
2014-01-01
影响因子：
6.5
通讯作者：
Vinereanu, Dragos
中科院分区：
文献类型：
--
作者：
Florescu, Maria;Magda, Lucia Stefania;Vinereanu, Dragos
背景：表柔比星是一种细胞毒性药物，广泛用于乳腺癌患者，但其应用因其心脏毒性而受到限制。进行左心室 (LV) 射血分数 (EF) 评估以证明心脏功能障碍。由于正常的 EF 可以掩盖左心室损伤，本研究的目的是评估使用斑点追踪超声心动图评估的变形和旋转是否代表早期表阿霉素诱导的心脏毒性的更好标志物。 方法：前瞻性招募了 40 名患有乳腺癌的女性（平均年龄，51 +/- 8 岁），计划接受基于表阿霉素的化疗。所有患者均接受常规超声心动图、组织速度成像和斑点追踪超声心动图，以评估左室几何形状和 EF、S'、变形（纵向、周向和径向应变和应变率）和旋转。在表阿霉素第三个和第六个周期后对患者进行重新评估（平均累积剂量，268 +/- 22 g/m(2)）。结果：在第六个周期治疗后，14 名患者 (35%) 出现表阿霉素诱导的心脏毒性（EF 下降 >10%，EF 为
Background: Epirubicin is a cytotoxic drug, widely used in patients with breast cancer, but its application is limited by its cardiotoxicity. Assessment of left ventricular (LV) ejection fraction (EF) is performed to demonstrate cardiac dysfunction. Because normal EF can mask LV impairment, the aim of this study was to evaluate whether deformation and rotation assessed using speckle-tracking echocardiography represent better markers of early epirubicin-induced cardiotoxicity.Methods: Forty women with breast cancer (mean age, 51 +/- 8 years), scheduled to be treated with epirubicin-based chemotherapy, were prospectively enrolled. All patients underwent conventional echocardiography, tissue velocity imaging, and speckle-tracking echocardiography to evaluate LV geometry and EF, S', deformation (longitudinal, circumferential, and radial strain and strain rate), and rotation. Patients were reevaluated after the third and sixth cycles of epirubicin (mean cumulative dose, 268 +/- 22 g/m(2)).Results: After the sixth cycle of treatment, 14 patients (35%) had developed epirubicin-induced cardiotoxicity (a decrease in EF of >10% to an EF of