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在人环素治疗期间异常的全球纵向应变预测了儿童未来的心脏毒性

Megan Gunsaulus^1,2, Tarek Alsaied^3,4, Jean M Tersak^3,5

¹Department of Pediatrics, University of Pittsburgh Medical Center, 4401 Penn Avenue, 5th Floor Faculty Pavilion, Pittsburgh, PA, 15224, USA. mgunsaulus17@gmail.com.

Pediatric cardiology

|August 22, 2023

概括

化疗期间全球纵向应变 (GLS) 的下降预测了儿童癌症患者接受高剂量人环素的晚期心脏功能障碍. 这种敏感标志物有助于早期发现心脏毒性,改善了幸存者的长期结果.

科学领域:

心脏病学心脏病学
儿科瘤学儿科瘤学
心脏瘤学 - 心脏瘤学

背景情况:

全球纵向应变 (GLS) 是成年人的敏感心脏功能指标.
它对接受 antracycline 治疗的儿科癌症患者心脏毒性的预测价值不太清楚.
早期发现心脏功能障碍对于管理长期副作用至关重要.

研究的目的:

评估全球纵向应变 (GLS) 以预测儿童癌症幸存者的晚期心脏功能障碍.
评估GLS在人环素治疗期间变化与心脏毒性之间的关联.
确定GLS作为潜在的早期心脏毒性生物标志物在这个人群中.

主要方法:

对接受 antracyclines (≥225 mg/m2 doxorubicin 相当剂) 的儿科患者进行了回顾性研究.
在化疗前,治疗期间和治疗后进行过胸腔心声图 (TTE).
通过降低LVEF,分数缩短或GLS下降 (比基线≥15%) 定义的心脏毒性.

主要成果:

33%的患者 (19/57) 在治疗后达到心脏毒性标准.
心脏毒性与治疗期间较低的LVEF (p=0.0003) 和显著的GLS降低 (p<0.0001) 有关.
在治疗期间GLS下降≥15%的最佳预测心脏毒性 (AUC0.87),包括治疗后>1年.

结论:

化疗期间全球纵向应变 (GLS) 的下降是儿科患者心脏毒性最强的预测因素.
GLS是监测心脏功能和预测儿童癌症幸存者的长期心脏事件的有价值的标志物.
这突显了GLS监测在接受环素治疗的儿科患者群体中的重要性.

关键词:

人类循环类化学疗法.癌症癌症癌症癌症心脏毒性有关心脏的毒性.心声回声扫描 (Echocardiography) 是一种心声回声扫描.儿科心脏病学儿科心脏病学压力应变是一种压力.

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