ACUTE RADIATION EFFECTS ON CARDIAC FUNCTION DETECTED BY STRAIN RATE IMAGING IN BREAST CANCER PATIENTS
ACUTE RADIATION EFFECTS ON CARDIAC FUNCTION DETECTED BY STRAIN RATE IMAGING IN BREAST CANCER PATIENTS
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DOI：
10.1016/j.ijrobp.2010.01.004
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发表时间：
2011-04-01
影响因子：
7
通讯作者：
Voigt, Jens-Uwe
中科院分区：
文献类型：
--
作者：
Erven, Katrien;Jurcut, Ruxandra;Voigt, Jens-Uwe
目的：探讨早期辐射引起的局部心功能变化的发生，应变率成像（SRI）通过tissue Doppler echocardiogram.Methods和Materials：我们包括20个左侧和10个右侧乳腺癌患者接受放疗（RT）的乳房或胸壁。在RT前（基线）、RT后即刻（RT后）和RT后2个月随访（FUP）时进行标准超声心动图和SRI。从所有18个左心室（LV）节段获得局部应变（S）和应变率（SR）值。结果：在左侧患者中观察到RT后和随访时S减少（Spost-RT：-17.6 +/-1.5%，S-FUP：-17.4 +/-2.3%，vs. S-基线：-19.5 +/-2.1%，p < 0.001），但在右侧患者中没有。在左侧患者组中，RT后左心室心尖段的S和SR显著降低（Spost-RT：-15.3 +/-2.5%，S-FUP：-14.3 3 3. 7%，对比S-基线：-19.3 +/-3.0%，p < 0.01; SRpost-RT：-1.06 +/- 0.15 s（-1），SRFUP：-1.16 +/- 0.28 s（-1）vs. SR基线：1.29 +/- 0.27 s（-1），p = 0.01），但在中段或基底段中未发现。此外，我们观察到暴露于超过3戈伊的节段显示RT后S显著降低（Spost-RT：-16.1 +/-1.6%，SFUP：-15.8 +/-3.4%，与S基线：-18.9 +/-2.6%，p < 0.001）。这不能被观察到在接受小于3戈伊的节段。结论：SRI显示RT后心肌功能的剂量相关性区域下降。它可能是一个有用的工具，在现代RT技术的评价，相对于心脏毒性。(C)2011 Elsevier Inc.
Purpose: To investigate the occurrence of early radiation-induced changes in regional cardiac function using strain rate imaging (SRI) by tissue Doppler echocardiography.Methods and Materials: We included 20 left-sided and 10 right-sided breast cancer patients receiving radiotherapy (RT) to the breast or chest wall. Standard echocardiography and SRI were performed before RT (baseline), immediately after RT (post-RT), and at 2 months follow-up (FUP) after RT. Regional strain (S) and strain rate (SR) values were obtained from all 18 left ventricular (LV) segments. Data were compared to the regional radiation dose.Results: A reduction in S was observed post-RT and at FUP in left-sided patients (Spost-RT: -17.6 +/- 1.5%, and S-FUP: -17.4 +/- 2.3%, vs. S-baseline:-19.5 +/- 2.1%, p < 0.001) but not in right-sided patients. Within the left-sided patient group, S and SR were significantly reduced after RT in apical LV segments (Spost-RT: -15.3 +/- 2.5%, and S-FUP: -14.3 3.7%, vs. S-baseline: -19.3 +/- 3.0%, p < 0.01; and SRpost-RT: -1.06 +/- 0.15 s(-1), and SRFUP: -1.16 +/- 0.28 s(-1), vs. SRbaseline: 1.29 +/- 0.27 s(-1), p = 0.01), but not in mid- or basal segments. Furthermore, we observed that segments exposed to more than 3 Gy showed a significant decrease in S after RT (Spost-RT: -16.1 +/- 1.6%, and SFUP: -15.8 +/- 3.4%, vs. S-baseline: -18.9 +/- 2.6%, p < 0.001). This could not be observed in segments receiving less than 3 Gy.Conclusions: SRI shows a dose-related regional decrease in myocardial function after RT. It might be a useful tool in the evaluation of modern RT techniques, with respect to cardiac toxicity. (C) 2011 Elsevier Inc.