在治疗期间患有心力衰竭的AML成年人心脏恢复的预测因素
Matthew Wu1, Kathryn Russell2, Carole M Shaw3
1University of Washington Medical Center, Seattle, WA.
JCO oncology practice
|April 3, 2025
概括
大约一半的急性髓性白血病 (AML) 患者在治疗期间排泄分数减少后无法康复. 缺血事件预测无法恢复,而指南导向医学治疗 (GDMT) 可能会改善结果.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 急性髓性白血病 (AML) 患者面临心脏风险升高,特别是因安赛克林化疗.
- 心力衰竭是AML幸存者死亡的重要原因.
- 了解影响心肌功能障碍和恢复的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了调查与心肌功能障碍相关的因素及其在AML治疗期间的恢复.
- 在AML患者中确定左心室射出小部分 (LVEF) 恢复的预测因子.
主要方法:
- 在诱导疗法期间减少LVEF的86名AML患者 (2008-2022) 的回顾性分析.
- 多变量分析以比较恢复LVEF的患者和没有恢复的患者之间的特征.
- 使用里程碑式审查的生存分析.
主要成果:
- 48%的患有系统性功能障碍的AML患者没有恢复LVEF.
- 不恢复与男性性别,年龄超过60岁,心血管风险因素和高风险白血病有关.
- 缺血相关的功能障碍预测无法恢复,而化疗相关的功能障碍预测恢复.
- 指南导向医学疗法 (GDMT) 的使用和剂量与LVEF恢复相关.
- 无法恢复LVEF增加了心脏特异性死亡率 (51%对23%).
结论:
- 几乎一半的AML患者在诱导治疗期间经历LVEF下降,可能无法恢复心脏功能.
- 在治疗期间发生的缺血事件是无法恢复的关键预测因素.
- GDMT可能提供预后益处,需要进一步调查.
- 需要进行前性研究,以建立AML患者的心脏管理算法.
更多相关视频
相关概念视频
01:17Pathophysiology of Heart Failure
1.4K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.4K
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
71
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
71
01:20Exercise and Cardiovascular Response
662
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
662