[高剂量化疗和自身造血干细胞移植后的患者的左心室功能障碍]
N A Potemkina1, P A Zeynalova1, G D Petrova2
1Sechenov First Moscow State Medical University.
Kardiologiia
|November 16, 2023
概括
高剂量化疗和干细胞移植可以影响心脏功能. 治疗后左心室全球纵向应变 (GLS) 的下降与手术前较高的NT-proBNP水平有关.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 血液学 血液学 血液学
背景情况:
- 高剂量化疗 (HDCT),其次是自身造血干细胞移植 (aHSCT) 是对血母细胞瘤的关键治疗方法.
- 在HDCT和aHSCT后出现左心室 (LV) 功能障碍的风险需要进一步调查.
- 心脏监测对于在密集癌症治疗期间检测亚临床心肌变化至关重要.
研究的目的:
- 评估HDCT和aHSCT后LV全球纵向应变 (GLS) 和其他心声学参数的变化.
- 在接受这种密集治疗方案的患者中确定LV功能障碍的预测因子.
- 在癌症治疗的背景下评估GLS动态的临床意义.
主要方法:
- 在HDCT/aHSCT前后,包括GLS评估在内的心声扫描 (EchoCG) 对74名血母细胞形成症患者 (20-65岁) 进行.
- 进行了心脏生物标志物的测量,包括素T和N-终端亲脑尿素 (NT-proBNP).
- 使用统计分析将GLS变化与基线生物标志物水平和临床结果相关联.
主要成果:
- 在治疗后,8.1%的患者观察到LV GLS显著下降 (≥15%与基线相比).
- 这种GLS减少与 elevated baseline NT-proBNP水平 (>125 pg/mL) 显著相关.
- 随着NT-proBNP升高,GLS降低的几率比为8.667 (95% CI,1.419-52.942;p=0.022).
结论:
- 在aHSCT后减少的LV GLS是心脏应变的潜在指标.
- 在HDCT/aHSCT之前的NT-proBNP水平升高可能预测LV GLS的后续下降.
- 这些发现强调了治疗前对接受密集癌症治疗的患者进行心脏评估和监测的重要性.
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