高血压对开发左心室功能障碍在患有恶性淋巴瘤的患者中最佳的Anthracycline累积剂量的影响
Yusuke Tanaka1, Hidekazu Tanaka2, Keiko Hatazawa3
1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
The international journal of cardiovascular imaging
|May 31, 2024
概括
高血压降低了安全的累积多克索鲁比辛剂量,增加了淋巴瘤患者左心室 (LV) 功能障碍的风险. 患有LV缩的高血压患者在较低剂量时面临更大的风险.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 人环素化疗,特别是多克索鲁比辛,可以导致剂量依赖的左心室 (LV) 功能障碍.
- 高血压是心力衰竭和化疗诱导的LV功能障碍的重要危险因素.
- 高血压对 LV 功能障碍在淋巴瘤患者的累积多克索鲁比辛剂量值的确切影响尚未确定.
研究的目的:
- 为了研究高血压如何影响最佳的总累积人环素剂量,以预防恶性淋巴瘤患者的LV功能障碍.
- 评估高血压和LV增高对多克索鲁比心脏毒性的联合影响.
主要方法:
- 对92名患有恶性淋巴瘤的患者进行了回顾性研究,这些患者保留了LV射出分数 (LVEF),接受了环素化疗.
- 在化疗前和化疗后2个月进行心声扫描,以评估 LV 功能和缩.
- LV 功能障碍定义为LVEF ≥5%的相对下降; LV 缩定义为同心缩.
主要成果:
- 在高血压患者 (259.3 mg/m2) 与非高血压患者 (358.9 mg/m2) 相比,对 LV 功能障碍的累积多克索鲁比辛切断剂量显著较低.
- 在患有 LV 缩的高血压患者中,预防 LV 功能障碍的临界累积多克索鲁比辛剂量显著降低至 40.1 mg/m2.
- 高血压,特别是 LV 缩,降低了 doxorubicin 诱导的 LV 功能障碍的门.
结论:
- 患有恶性淋巴瘤的高血压患者在较低的累积多克索鲁比辛剂量下,患有LV功能障碍的风险更高.
- 在高血压患者中存在LV缩进一步加剧了这种风险,需要谨慎的剂量管理.
- 这些发现对于在高血压淋巴瘤患者中量身定制抗环素化疗剂量以减轻心脏毒性具有临床意义.
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