三维斑点追踪成像评估紫杉醇联合卡铂治疗卵巢癌患者左心室收缩功能

目的探讨三维斑点追踪成像(3D-STI)评估紫杉醇联合卡铂治疗卵巢癌患者左心室整体收缩功能的应用价值。方法对30例经病理确诊的卵巢癌患者(卵巢癌组)以紫杉醇联合卡铂化学治疗(简称化疗),于化疗前及化疗3、6个周期结束时行3D-STI,获取左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、球形指数(SPI)、左心室舒张末期质量(LVEDmass)、左心室收缩末期质量(LVESmass)及左心室整体纵向应变(GLS)、整体圆周应变(GCS)、整体径向应变(GRS)、整体面积应变(GAS),并与30名健康志愿者(对照组)进行对比。采用ROC曲线分析各应变参数对卵巢癌患者化疗后心功能受损的诊断效能。结果与对照组比较,卵巢癌组化疗3个和6个周期时LVEDV、LVEF降低,LVEDmass、LVESmass升高,左心室GLS、GCS、GRS、GAS均降低,且6个周期结束时更显著(P均0.05)。收缩期峰值应变参数诊断卵巢癌患者化疗后心功能的ROC曲线显示,化疗3个周期时GAS的AUC(0.944)及特异度(96.67%)均最高,GLS、GCS的敏感度最高(均为90.00%);化疗6个周期时GAS的AUC(0.953)及特异度(96.67%)最高,GLS的敏感度(93.33%)最高。结论 3D-STI可早期评估紫杉醇联合卡铂治疗卵巢癌患者左心室收缩功能。

Three-dimensional speckle tracking imaging in evaluation on left ventricular systolic function of Paclitaxel combined with Carboplatin in patients with ovarian cancer

Objective To explore the application value of three-dimensional speckle tracking imaging (3D-STI) in evaluation on changes of left ventricular systolic function caused by Paclitaxel combined with Carboplatin for treatment of ovarian cancer. Methods Thirty patients with pathologically diagnosed ovarian cancer (ovarian cancer group) were selected and treated with Paclitaxel combined with Carboplatin chemotherapy. 3D-STI examination was performed before chemotherapy and at the end of 3 and 6 cycles of chemotherapy to obtain left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), spherical index (SPI), left ventricular end diastolic mass (LVEDmass), left ventricular end systolic mass (LVESmass), left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and global area strain (GAS), and the indexes compared with those of 30 healthy volunteers (control group). ROC curve was used to analyze the diagnostic efficacy of various strain parameters for cardiac function abnormalities in patients with ovarian cancer after chemotherapy. Results Compared with control group, LVEDV and LVEF decreased, LVEDmass and LVESmass increased, and left ventricular GLS, GCS, GRS and GAS decreased after 3 and 6 cycles of chemotherapy in ovarian cancer group (all P<0.05). ROC curve of systolic peak strain parameters for diagnosis of cardiac function in patients with ovarian cancer after chemotherapy showed that AUC (0.944) and specificity (96.67%) of GAS were the highest at the end of 3 cycles of chemotherapy while GLS and GCS had the highest sensitivity (90.00%).At the end of 6 cycles of chemotherapy, GAS had the highest AUC (0.953) and specificity (96.67%), and GLS had the highest sensitivity (93.33%). Conclusion 3D-STI can early detect of left ventricular systolic function in patients with ovarian cancer treated with Paclitaxel combined with Carboplatin.