化疗诱导的右心室心肌病;一个系统的审查和元分析
Pramod Theetha Kariyanna1, Ashish Kumar2, Amog Jayarangaiah3
1Department of Cardiology, Chaparral Medical Group/Pomona Valley Hospital Medical Center, Pomona, CA, United States.
Frontiers in cardiovascular medicine
|August 21, 2023
概括
人环素和/或特拉斯图祖马布化学疗法显著降低右心室喷射分数 (RVEF) 和RV分数面积变化 (RVFAC). 这项研究强调了这些常见的乳腺癌治疗对右心室功能的负面影响.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 心脏瘤学是一门专业.
背景情况:
- 左心室功能障碍是已知的化疗副作用.
- 关于化疗对右心室 (RV) 功能影响的数据有限.
研究的目的:
- 在乳腺癌患者中比较化疗前后的RV参数.
- 通过使用二维回声心脏成像来评估antracycline和/或trastuzumab对RV功能的影响.
主要方法:
- 在PubMed,EMBASE和Cochrane数据库中进行系统搜索 (直到2021年11月).
- 使用逆方差方法的元分析与随机效应模型.
- 计算的平均差异 (MD) 与95%的置信区间 (CI).
主要成果:
- 包括15项研究 (644名患者),随访时间<12个月).
- 在RVEF (MD:2.70,P=0.03) 和RVFAC (MD:3.74,P<0.01) 中观察到显著的减少.
- 左心室喷射分数 (LVEF) 也显著下降 (MD:4.04,P<0.01),而三环状平面缩外流 (TAPSE) 没有显著变化.
结论:
- 人环素和/或拉斯图祖马布化疗对VR功能产生负面影响.
- 化疗导致RVEF,RVFAC和LVEF的下降.
- 在治疗期间和治疗后监测RV功能至关重要.
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