乳腺癌患者的详细心声表现:随访3年期间与排泄率下降,恢复和心力衰竭症状的关联
Hari K Narayan1, Brian Finkelman1, Benjamin French1
1From Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, PA (H.K.N.); Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (B. Finkelman, B. French, B.K.); and Department of Medicine, Division of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (B. Finkelman, T.P., D.H., A.M.S., K.B.M., B.K.).
乳腺癌治疗,如多克索鲁比辛和特拉斯图祖马布,导致左心室射出分数 (LVEF) 在三年内适度持续下降. 心脏体积的变化,压力和心室动脉合预测LVEF变化和心力衰竭症状.
科学领域:
- 心脏病学
- 癌症学
- 心脏瘤学
背景情况:
- 心血管疾病是乳腺癌患者日益关注的问题.
- 德克索鲁比辛和特拉斯图祖马布对心脏重塑的长度影响尚不清楚.
研究的目的:
- 确定心脏结构,功能和心室动脉合的回声心脏学变化.
- 评估与左心室喷射分数 (LVEF) 的下降和恢复的关联.
- 评估与心力衰竭症状的联系.
主要方法:
- 对277名接受多克索鲁比辛,特拉斯图祖马布或两者的乳腺癌患者进行前性队列研究.
- 在2. 0年的中位随访期内收集的1249张心声图.
- 使用重复测量回归模型分析心脏结构,功能和心室-动脉合.
主要成果:
- 在3年后,多克索鲁比辛和特拉斯图祖马布导致了温和而持续的LVEF下降.
- 在Dox+Tras组中,LVEF初始下降幅度最大,部分恢复.
- 卷,应变和心室-动脉合 (Ea/Eessb) 与LVEF变化和心力衰竭症状相关.
结论:
- doxorubicin 和 trastuzumab 导致 LVEF 缓慢持续下降长达 3 年.
- 心脏体积,应变和心室动脉合变化是LVEF变化和恢复的关键指标.
- 这些心声学参数预测乳腺癌患者的LVEF轨迹和心力衰竭的发展.
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