卡维地洛预防蒽环类药物治疗乳腺癌患者右心室功能障碍的效果评价。

Mersede Karvandi, Mojtaba Ghadyani, Nahid Mohebbi, Mehdi Tabarraee, Sina Salari
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摘要

背景:今天,研究表明,在癌症治疗期间,右心室壁运动异常或右心室功能障碍是可能发生的。现在,考虑到卡维地洛对β 1、2和α受体的影响及其抗氧化特性,它似乎可以预防RV异常。因此,本研究的目的是探讨卡维地洛在预防蒽环类药物治疗的乳腺癌患者RV功能障碍中的可能保护作用。材料与方法:本研究对23例乳腺癌患者进行了单盲临床试验研究,其中12例患者仅接受蒽环类抗肿瘤药物阿霉素(阿霉素®)化疗(对照组),11例患者在蒽环类药物的基础上接受卡维地洛治疗。为了评估卡维地洛的效果,患者在干预前和蒽环类药物治疗结束后2周进行了经胸超声心动图检查。结果:卡维地洛组右心室射血分数和右心室分数面积变化两项参数平均值分别为66.41%±8.10%和51.85%±6.89%,略高于对照组的64.58%±6.83%和50.48±5.79%,差异无统计学意义(P > 0.05)。对照组RV S波组织多普勒成像(S- tdi)平均值为0.13±0.02 m/ S,显著低于卡维地洛组的平均值0.14±0.02 m/ S (P = 0.022)。结论:根据本研究结果,与对照组相比,卡维地洛作为防腐剂对右心室功能的改善效果明显,但差异无统计学意义。
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Evaluation of the Effect of Carvedilol in Preventing Right Ventricular Dysfunction in Breast Cancer Patients Receiving Anthracycline.

Background: Today, it has been shown that it is possible for right ventricular (RV) wall motion abnormalities or RV functional disorders to occur during cancer treatment. Now, considering the effect of carvedilol on beta 1, 2, and alpha receptors and its antioxidant properties, it seems that it can prevent RV abnormalities. Therefore, the aim of this study was to investigate the possible protective effects of carvedilol in preventing RV dysfunction in patients with breast cancer treated with anthracyclines.

Materials and methods: The present single-blind clinical trial study was performed on 23 patients with breast cancer that 12 of them received only the anthracycline antineoplastic doxorubicin (Adriamycin®) chemotherapy (control group) and 11 patients received carvedilol in addition to anthracycline. To evaluate the effect of carvedilol, patients underwent transthoracic echocardiography before intervention and 2 weeks after the end of treatment with anthracyclines.

Results: The two parameters of RV ejection fraction and RV fractional area change in the carvedilol group with a mean of 66.41% ± 8.10% and 51.85% ± 6.89% were slightly higher than the control group with a mean of 64.58% ± 6.83% and 50.48 ± 5.79%, respectively, which was not statistically significant (P > 0.05). In contrast, RV S wave tissue Doppler imaging (S-TDI) in the control group with a mean of 0.13 ± 0.02 m/s was significantly lower than the carvedilol group with a mean of 0.14 ± 0.02 m/s (P = 0.022).

Conclusion: According to the results of the present study, the effect of using carvedilol as a preservative on improving RV function was seen compared to the control group, although this difference was not statistically significant.

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