免疫检查点抑制剂后心肌损伤:澳大利亚的经验
Briella K Egberts1, Rajiv Ananthakrishna2, Rebecca Perry3
1College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, SA, Australia; South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
Heart, lung & circulation
|April 9, 2025
概括
免疫检查点抑制剂 (ICI) 可能会导致亚临床心肌损伤,通过先进的心脏成像检测到,尽管低托罗激素增加. 进一步的研究对于了解ICI心脏毒性至关重要.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是一种重要的癌症疗法.
- 有关ICI诱导的心脏毒性,特别是亚临床心肌损伤存在担忧.
- 关于ICI相关心脏并发症发生率的局部数据有限.
研究的目的:
- 在接受ICI治疗的患者中评估亚临床心肌损伤,而没有先前存在的心血管疾病.
- 使用生物化学标记物和先进的心脏成像来检测心肌损伤.
- 在这个患者群体中评估心脏并发症的发生率.
主要方法:
- 对41名接受ICI治疗的患者进行前性试点研究.
- 连续评估包括心脏素I (cTnI),NT-proBNP,带有应变分析的回声心脏学和6周心脏MRI (CMR).
- 为了进行比较,纳入了对照组 (n=10).
主要成果:
- 观察到cTnI显著增加的低发病率 (2.7%).
- 在ICI组中,左心室全球纵向应变 (LV-GLS) 显著下降.
- 在55%的患者中,CMR显示出异常,其中45%显示T1映射增加与LV-GLS减少相关.
- 在1年内,主要心脏不良事件发生在45.9%的患者中.
结论:
- 亚临床心肌损伤可以通过ICI后启动的先进心脏成像检测到,尽管平素升高较低.
- 这些发现强调需要进行更大的研究来调查ICI心脏毒性患病率,机制和临床影响.
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