实时三维超声心动图联合速度向量成像技术评价乳腺癌蒽环类药物化疗后患者的左心房功能

目的:采用实时三维超声心动图(real-time three-dimensional echocardiography, RT-3DE)及速度向量成像技术(velocity vector imaging, VVI)评价蒽环类药物(anthracycline, ATC)化疗后乳腺癌患者的左心房功能。方法:纳入我院行ATC化疗的女性乳腺癌术后患者72例，分别采集化疗前、化疗3个周期(化疗中)、化疗6个周期(化疗后)三个阶段的超声心动图参数。获取RT-3DE图像，得到左心房舒张末容积(left atrial end-diastolic volume, LAV_max)、左心房收缩前容积(left atrial pre-systolic volume, LAV_prep)、左心房收缩末容积(left atrial end-systolic volume, LAV_min),计算左心房主动射血分数(left atrial active ejection fraction, LAAEF)、左心房总射血分数(left atrial tota...

Evaluation of left atrial function in breast cancer patients treated with anthracycline by real-time three-dimensional echocardiography combined with velocity vector imaging

Objective:To evaluate the left atrial function of breast cancer patients with anthracycline（ATC) chemotherapy by real-time three-dimensional echocardiography（RT-3DE) and velocity vector imaging（VVI).Methods:72 female breast cancer patients who underwent ATC chemotherapy in our hospital were enrolled.Echocardiographic parameters were collected at three stages,including before chemotherapy,3 cycles of chemotherapy（during chemotherapy) and 6 cycles of chemotherapy（after chemotherapy).Left atrial end-diastolic volume（LAVmax),left atrial pre-systolic volume（LAVprep) and left atrial end-systolic volume（LAVmin) were obtained by RT-3DE imaging.Left atrial active ejection fraction（LAAEF) and left atrial total ejection fraction（LATEF) were calculated.The peak systolic strain（Ss) and strain rate（s-SR) of left atrium and peak diastolic strain（Sa) and strain rate（a-SR) of left atrium were obtained by four cavity heart apex 2D image.Results:LAVmax,LAVprep and LAVmin increased after chemotherapy compared with during chemotherapy（P<0.05).LAAEF and LATEF were lower after chemotherapy than before and during chemotherapy（P<0.05).Compared with before chemotherapy,Ss,s-SR and a-SR decreased in during chemotherapy and after chemotherapy,and Ss,s-SR and a-SR also decreased after chemotherapy compared with during chemotherapy（P<0.05).There was no significant difference in Sa among the three stages（P>0.05).Conclusion:ATC chemotherapy can reduce the function of left atrial storage and pump in breast cancer patients,and the damage is more serious in the later stage of chemotherapy.RT-3DE and VVI can sensitively detect the changes of left atrial function in breast cancer patients after chemotherapy from different angles,providing good application value for early clinical detection and timely change of treatment plan.