运用心肌综合指数预测蒽环类药物早期心脏毒性的可行性研究

目的 通过实时三维斑点追踪成像技术(three-dimensional speckle tracking imaging,3D-STI)获取左心室心肌综合指数(myocardial composite index,MCI),探讨该参数对乳腺癌患者术后蒽环类化学药物治疗所致早期心肌毒性的可行性.方法 选取58例欲行6周期...

A feasibility study of predicting early cardiotoxicity in patients with anthracycline chemotherapy by using myocardial comprehensive index

Objective Usinging the left ventricular myocardial composite index(MCI)by three-dimensional speckle tracking imaging(3D-STI),we investigated the feasibility of early myocardial toxicity in breast cancer patients after receiving anthracycline chemotherapy.Methods A prospective study was performed on 58 patients with breast cancer who had undergone 6 cycles of anthracycline chemotherapy.The routine echocardiography and 3D-STI parameters were monitored before chemotherapy and within 24~48 hours after receiving third(medium)and sixth cycle(late)of chemotherapy.The left ventricular related strain and torsion parameters were obtained by processing image and software analysis.The left ventricular myocardial comprehensive index(MCI)was calculated.The statistical differences of related parameters in different chemotherapy stages were compared.The receiver operating characteristic curve(ROC)was used to evaluate the feasibility of three-dimensional parameters related to left ventricular diagnosis of early cardiac toxicity;Simultaneously,we monitored serum Hs-cTnT concentration in patients with different chemotherapy stages,and studied the correlation with MCI.Results Compared with no the chemotherapy,the MCI showed a significant decrease(P<0.05)at the 3rd cycle of chemotherapy.The area under the receiver operating characteristic curve of MCI was 0.925,and the cutoff value was-235.75(%×°).The sensitivity of anthracycline-induced cardiotoxicity was 91.4%,and the specificity was 86.2%,which was higher than other parameters.When the chemotherapy was completed,the serum Hs-cTnT value was gradually increased,and the difference was statistically significant,although the data were within the normal range.Pearson correlation analysis showed that MCI in different chemotherapy stages was negatively correlated with serum Hs-cTnT concentration(r=-0.595,P<0.05)in the middle stage of chemotherapy(r=-0.631,P<0.05)in the late stage of chemotherapy.Conclusion In the course of chemotherapy,the new parameter MCI obtained by 3D-STI is used to evaluate the sensitivity and specificity of anthracycline cardiotoxicity.It is feasible for early detection of left ventricular myocardial toxicity in breast cancer patients caused with anthracyclines.