激素阳性绝经后乳腺癌患者接受芳香酶抑制剂的心脏毒性评估

R. Faheim, Eman A. El-Shaarawy, D. Salem, Rehab G. Shaaban
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摘要

背景:芳香酶抑制剂(AIs)是激素受体阳性的绝经后早期或转移性乳腺癌患者的有效内分泌治疗方法。目的:评价激素阳性绝经后乳腺癌患者接受AIs(前期或转换治疗)的心脏毒性。方法:本横断面研究纳入了2016年8月至2017年6月期间在埃及开罗艾因沙姆斯大学临床肿瘤科就诊的123例绝经后乳腺癌患者,这些患者接受了激素受体阳性的芳香酶抑制剂治疗。为了评估这些患者的心脏毒性,他们接受了血压和血脂测量、心电图(ECG)、结果:患者年龄41 ~ 85岁,平均年龄61岁。超声心动图显示心脏毒性71例(57.7%)。与年龄≥62岁、IHD、HTN病史、DM相关(p值分别为0.001、0.001、0.017、0.035)。然而,切换治疗和术前人工智能时,心脏毒性与血压变化、血脂变化、心电图和ECHO变化的相关性无统计学意义(p值分别为0.275、0.116、0.081和0.761)。结论:接受芳香酶抑制剂的激素阳性绝经后乳腺癌患者的心脏毒性评估显示,仅通过ECHO检测到的一半患者(57.7%)存在心脏毒性。他们在接受转换治疗或预先人工智能治疗时显示出统计学上不显著的相关性
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Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving aromatase inhibitors
Background: Aromatase inhibitors (AIs) represent an effective endocrine treatment for hormone receptor-positive postmenopausal breast cancer patients with early stage or metastatic disease.Objective: Assessment of Cardiotoxicity in Hormone positive Postmenopausal Breast Cancer Patients receiving AIs (upfront orswitch therapy).Methods: This cross sectional study included 123 postmenopausal breast cancer patients presented to the Clinical Oncology Department, Ain Shams University (Cairo, Egypt) in the interval from August 2016 to June 2017 with hormone receptor positive receiving Aromatase Inhibitors, To assess cardiotoxicity in these patients, they were subjected to blood pressure and lipid profile measurement, electrocardiography (ECG), and electrocardiography (ECHO) and classified into patients had Nolvadex then A.I (arm 1) and others had upfront A.I (arm 2).Results: The age of patients ranged from 41 years to 85 years with mean age of 61 years. Seventy one patients (57.7%) showed cardiotoxicity as assessed by ECHO. They showed significant correlation with rising age above 62 years, IHD, history of HTN and DM (p value: .001, .001, .017 and 0.035 respectively). However, correlation between cardiotoxity and blood pressure changes, lipid profile changes and ECG findings and ECHO changes in switch therapy and upfront A.I were not statistically significant (p value = .275, .116, .081 and .761 respectively).Conclusion: Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving Aromatase Inhibitors showed evidence of cardiotoxicity in half the patients (57.7%) as detected by ECHO only. They showed statistically non significant correlations either recievied switch therapy or upfront A.I.
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