Torsion analysis in the early detection of anthracycline-mediated cardiomyopathy
Torsion analysis in the early detection of anthracycline-mediated cardiomyopathy
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DOI：
10.1093/ejechocard/jer172
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发表时间：
2012-01-01
影响因子：
6.2
通讯作者：
Ikeda, Uichi
中科院分区：
文献类型：
--
作者：
Motoki, Hirohiko;Koyama, Jun;Ikeda, Uichi
目的蒽环类药物对心脏的结构和功能有深远的影响，随着时间的推移，会引起心肌病，导致充血性心力衰竭。早期检测低剂量蒽环类药物治疗后的亚临床左心室功能障碍可能是一种预防策略。本研究的目的是确定扭转分析，使用二维斑点追踪成像（STI），用于检测早期蒽环类药物介导的cardiotoxic.Methods和结果常规和多普勒超声心动图图像，从25例（平均年龄58 +/- 11岁）化疗前和治疗后1个月和3个月。1个月和3个月时蒽环类抗生素累积剂量分别为98 +/- 59和170 +/- 87 g/m2。在标准超声心动图后，使用STI分析心尖和基底短轴图像的LV扭转和扭转速度曲线。整个随访期间，左心室尺寸和射血分数没有变化。化疗后3个月等容舒张时间延长，其他多普勒指标无明显变化。化疗后1个月，扭转率（P < 0.0001）、扭转率（P < 0.0001）和解扭率（P < 0.001）均显著下降。蒽环类药物累积剂量与左室扭转呈显著负相关（r = 20.524，P < 0.0001）。结论左室扭转分析可作为早期检测蒽环类药物亚临床心脏毒性的无创性方法。
Aims Anthracyclines have profound consequences on the structure and function of the heart, which over time cause a cardiomyopathy that leads to congestive heart failure. Early detection of subclinical left ventricular (LV) dysfunction following a low dose of anthracyclines may be a preventive strategy. The aim of this study was to determine torsion analysis using two-dimensional speckle-tracking imaging (STI), useful for detecting early anthracycline-mediated cardiotoxicity.Methods and results Conventional and Doppler echocardiography images were obtained from 25 patients (mean age 58 +/- 11 years) before chemotherapy and 1 and 3 months after treatment. The cumulative anthracycline doses were 98 +/- 59 and 170 +/- 87 g/m(2) at 1 and 3 months, respectively. After standard echocardiography, LV torsion and twisting velocity profiles from apical and basal short-axis images were analysed using STI. LV dimensions and ejection fraction did not change throughout follow-up. Although isovolumic relaxation time showed prolongation 3 months after chemotherapy, other Doppler indices did not show significant changes. However, significant deteriorations in torsion (P < 0.0001 by ANOVA), twisting rate (P < 0.0001 by ANOVA), and untwisting rate (P < 0.001 by ANOVA) were found 1 month after chemotherapy. A significant negative correlation was observed between cumulative anthracycline doses and torsion (r = 20.524, P < 0.0001).Conclusion LV torsion analysis could be a useful non-invasive approach for early detection of subclinical anthracycline cardiotoxicity.