Early diastolic strain rate measurements by cardiac MRI in breast cancer patients treated with trastuzumab: a longitudinal study
Early diastolic strain rate measurements by cardiac MRI in breast cancer patients treated with trastuzumab: a longitudinal study
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DOI：
10.1007/s10554-018-1482-2
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发表时间：
2019-04-01
影响因子：
2.1
通讯作者：
Yan, Andrew T.
中科院分区：
文献类型：
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作者：
Gong, Inna Y.;Ong, Geraldine;Yan, Andrew T.
我们通过心血管磁共振（CMR）评估舒张早期应变率的时间变化，作为曲妥珠单抗诱导的心室功能障碍的早期检测器。我们对41名接受连续CMR（基线、6、12和18个月）的曲妥珠单抗治疗乳腺癌女性进行了一项前瞻性、多中心、纵向观察性研究。两名设盲的阅片员独立测量左心室射血分数（LVEF）、峰值收缩应变参数（总体纵向应变[GLS]和总体周向应变[GCS]）和舒张早期应变率参数（总体纵向舒张期应变率[GLSR-E]、总体周向舒张期应变率[GCSR-E]和总体径向舒张期应变率[GRSR-E]），通过使用CMR 42的特征跟踪（FT-CMR）。6个月时，收缩期峰值应变GLS和GCS显著下降（p=0.024和p 0.10），LVEF和GCSR-E之间存在轻微显著弱相关性（p=0.046）。在无明显心脏毒性的曲妥珠单抗治疗患者中，与收缩期应变和LVEF下降相反，FT-CMR衍生的舒张期应变率参数在长达18个月内没有一致的时间变化。通过FT-CMR测定的收缩期应变可能比舒张期应变率更适用于监测亚临床曲妥珠单抗相关心肌dysfunction.ClinicalTrials.gov标识符NCT 01022086。
We evaluated temporal changes in early diastolic strain rates by cardiovascular magnetic resonance (CMR) as an early detector of trastuzumab-induced ventricular dysfunction. We conducted a prospective, multi-centre, longitudinal observational study of 41 trastuzumab-treated breast cancer women who underwent serial CMR (baseline, 6, 12, and 18months). Two blinded readers independently measured left ventricular ejection fraction (LVEF), peak systolic strain parameters (global longitudinal strain [GLS] and global circumferential strain [GCS]), and early diastolic strain rate parameters (global longitudinal diastolic strain rate [GLSR-E], global circumferential diastolic strain rate [GCSR-E], and global radial diastolic strain rate [GRSR-E]), by feature tracking (FT-CMR) using CMR42. There was a significant decline in peak systolic strain GLS and GCS at 6months (p=0.024 and p0.10), and a marginally significant weak correlation between LVEF and GCSR-E (p=0.046). Among trastuzumab-treated patients without overt cardiotoxicity, there was no consistent temporal change in FT-CMR-derived diastolic strain rate parameters up to 18months, in contrast to decline in systolic strain and LVEF. Systolic strains by FT-CMR are likely more useful than diastolic strain rates for monitoring subclinical trastuzumab-related myocardial dysfunction.ClinicalTrials.gov identifier NCT01022086.