乳腺癌多柔比星化疗后左心室收缩和舒张功能的变化

I. A. Karput, V. A. Snezhitskii, M. Kurbat, V. A. Gorustovich, Yu. I. Karpovich, A. Y. Rubinskii, T. A. Smirnova, A. Babenka
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引用次数: 0

摘要

简介在恶性肿瘤化疗(CT)期间检测心脏毒性效应是执业医生最重要的任务之一。目的:使用超声心动图(EchoCG)研究原发性乳腺癌(BC)患者在接受多柔比星化疗期间左心室收缩和舒张功能的变化,并确定早期心脏毒性(CT)的潜在标志物。研究对象包括在医疗机构 "格罗德诺大学诊所"(白俄罗斯格罗德诺)接受治疗的100名确诊为乳腺癌的患者。在研究样本中,对 100 名乳腺癌患者化疗前后的一系列 EchoCG 参数进行了测量。根据全纵向应变(GLS)相对减少百分比临界值的选择,在有 CT 和无 CT 的分组(化疗前和化疗后)中记录了不同的中值。数据显示了有 CT 和无 CT 亚组之间 EchoCG 指标的相对动态差异(%),说明了化疗结束后亚组之间的差异(%)有多大。在没有显著统计学差异的背景下,我们记录了指标增减的趋势,这可以将它们描述为潜在的CT标志物。我们假设,在亚临床阶段,收缩末期容积指数、舒张末期容积指数、二尖瓣环侧向运动的舒张早期峰值速度可与GLS一起被视为潜在的CT标志物;如果无法测量GLS的相对下降,这些指标可共同表明亚临床阶段CT效应的发展。在诊断 GLS 指数相对下降小于 15%但大于 10%时,如果化疗结束后收缩末期容积指数增加 10%或更多,我们建议将其作为早期 CT 效应的标志物。
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Changes in left ventricular systolic and diastolic function after chemotherapy for breast cancer with doxorubicin
Introduction. Detection of the cardiotoxic effect during chemotherapy (CT) for malignant neoplasms is one of the most important tasks of a practicing physician. Purpose: to study changes in left ventricular systolic and diastolic function using echocardiography (EchoCG) during chemotherapy with doxorubicin in patients with primary breast cancer (BC) and to identify potential markers of early cardiotoxicity (CT).Material and Methods. The study included 100 patients with a confirmed diagnosis of breast cancer who were treated at the health care institution “Grodno University Clinic” (Grodno, Belarus).Results. In the study sample, a number of EchoCG parameters were measured before and after chemotherapy in 100 patients with breast cancer. Depending on the choice of the threshold level of relative reduction in global longitudinal strain (GLS) in %, different median values were recorded in the subgroups with and without CT (before and after chemotherapy). Data are presented on the difference in the relative dynamics of EchoCG indicators in % between the subgroups with CT and without CT, which shows how large the differences between the subgroups are in % after the end of chemotherapy. Against the background of the absence of statistically significant differences, trends towards an increase or decrease in indicators were recorded, which can characterize them as potential CT markers.Conclusion. We hypothesize that indexed end-systolic volume, indexed end-diastolic volume, early diastolic peak velocity of lateral mitral annulus motion may be considered as potential CT markers in the subclinical stage along with GLS; if it is impossible to measure a relative decrease in GLS, these indicators collectively may indicate the development of a CT effect at the subclinical stage. When diagnosing a relative decrease in the GLS index by less than 15 %, but by more than 10 %, we propose to consider the indexed end-systolic volume index as a marker of the early CT effect if its increase after the end of chemotherapy is recorded by 10 % or more, respectively.
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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