Minor increases in plasma troponin I predict decreased left ventricular ejection fraction after high-dose chemotherapy
Minor increases in plasma troponin I predict decreased left ventricular ejection fraction after high-dose chemotherapy
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DOI：
10.1373/49.2.248
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发表时间：
2003-02-01
影响因子：
9.3
通讯作者：
Cipolla, CM
中科院分区：
文献类型：
--
作者：
Sandri, MT;Cardinale, D;Cipolla, CM
背景：在接受高剂量化疗（HDCT）治疗的侵袭性恶性肿瘤患者中，心脏tropdnin I （cTnI）升高被认为是晚期HDCT诱导的心功能障碍的早期标志。我们研究了Stratus CS （Dade Behring）测量的cTnI是否可以检测HDCT治疗患者的最小cTnI增加。方法：对179例连续患者在HDCT前、治疗结束时、治疗12、24、36、72 h后的血浆cTnI浓度进行测定，并在随访期间通过超声心动图检测心功能，记录左室射血分数（LVEF）。LVEF与基线值的最大差异被用作衡量心脏损伤的指标。在99名健康志愿者中，第99百分位数为0.07马克杯/升。根据ROC曲线分析（曲线下面积为0.89），选择0.08马克杯/L为下限（灵敏度82%，特异性77%）。57例（32%）患者的cTnI大于或等于0.08马克杯/升，超声心动图监测显示LVEF平均下降18%。相比之下，ctni阴性患者组LVEF平均下降2.5% (P
Background: Increased cardiac tropdnin I (cTnI) in patients treated with high-dose chemotherapy (HDCT) for aggressive malignancy has been proposed as an early marker of late HDCT-induced cardiac dysfunction. We investigated whether cTnI measured by the Stratus CS (Dade Behring) would allow detection of minimal cTnI increases in patients treated with HDCT.Methods: Plasma cTnI concentrations were determined in 179 consecutive patients before HDCT, at the end of the treatment, and after 12, 24, 36, and 72 h. Cardiac function was explored by echocardiography, and left ventricular ejection fraction (LVEF) was recorded during follow-up. The greatest variation in LVEF from the baseline value wag used as a measure of cardiac damage.Results. In 99 healthy volunteers, the 99th percentile was at 0.07 mug/L. On the basis of ROC curve analysis (area under the curve, 0.89), a cutoff of 0.08 mug/L was chosen (sensitivity, 82%; specificity, 77%). cTnI greater than or equal to0.08 mug/L occurred in 57 patients (32%) with echocardiographic monitoring revealing a mean decrease in LVEF of 18%. In comparison, the group of cTnI-negative patients had a mean decrease in LVEF of 2.5% (P