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首页> 外文期刊>Canadian Journal of Physiology and Pharmacology >Early detection of anthracycline-mediated cardiotoxicity: The value of considering both global longitudinal left ventricular strain and twist
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Early detection of anthracycline-mediated cardiotoxicity: The value of considering both global longitudinal left ventricular strain and twist

机译：蒽环类药物介导的心脏毒性的早期发现：同时考虑整体纵向左心室应变和扭曲的价值

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Anthracyclines are important anticancer drugs, but their use is limited by cardiotoxicity. Left ventricular ejection fraction (LVEF) is often inadequate to detect myocardial disease induced by chemotherapy. Tissue Doppler and bidimensionalstrain imaging could detect LV myocardial dysfunction earlier than LVEF. In drug-induced cardiotoxicity, torsional and longitudinal LV deformations [LV twist (LVtw), radial strain (GRS), global longitudinal strain (GLS)] are damaged. We assessed whether a new index, GLS×LVtw, could predict future anthracycline-induced cardiomyopathy. Echocardiography, troponin, and natriuretic peptide determination were prospectively performed in 74 patients before and after 6, 12, 24, and 52 weeks of anthracycline treatment. These patients were treated for breast cancer, Hodgkin's or non-Hodgkin's lymphoma, acute lymphoblastic or myeloblastic leukaemia, or osteosarcoma. At 6 weeks after initiation of chemotherapy, isovolumic relaxation time, systolic mitral annular velocity, LVGLS, LVGRS, LV apical rotation, LVtw, and GLS×LVtw deteriorated, and troponin levels became elevated (all p < 0.05 by ANOVA) before LVEF decreased. The receiver operating characteristic curves identified early deterioration of GLS×LVtw as the best predictor of later cardiotoxicity (area under curve = 0.93), followed by GLS (0.84) and LV apical rotation (0.81) deterioration. In conclusion, early change in the GLS×LVtw index seems to be a good predictor of future development of anthracycline-induced cardiotoxicity.
机译：蒽环类药物是重要的抗癌药物，但其使用受到心脏毒性的限制。左心室射血分数（LVEF）通常不足以检测化学疗法诱发的心肌病。组织多普勒和二维应变成像可以比LVEF更早地发现LV心肌功能障碍。在药物诱发的心脏毒性中，扭转和纵向LV变形[LV扭曲（LVtw），径向应变（GRS），整体纵向应变（GLS）]受到破坏。我们评估了新的指标GLS×LVtw是否可以预测未来蒽环类药物引起的心肌病。在蒽环类药物治疗6、12、24和52周之前和之后，对74例患者进行了超声心动图，肌钙蛋白和利钠肽测定。这些患者接受了乳腺癌，霍奇金淋巴瘤或非霍奇金淋巴瘤，急性淋巴细胞性或骨髓性白血病，骨肉瘤的治疗。化疗开始后第6周，等容血管舒张时间，收缩期二尖瓣环速度，LVGLS，LVGRS，LV顶尖旋转，LVtw和GLS×LVtw恶化，肌钙蛋白水平升高（在LVEF降低前均为p <0.05）。接受者的工作特征曲线确定了GLS×LVtw的早期恶化是后期心脏毒性的最佳预测指标（曲线下面积= 0.93），其次是GLS（0.84）和LV顶旋（0.81）恶化。总之，GLS×LVtw指数的早期变化似乎是蒽环类药物引起的心脏毒性未来发展的良好预测指标。

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