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解码与 antracycline 和 trastuzumab 相关的心脏功能障碍的预测:HFA-ICOS 得分与菌株成像相比

Hai Hoang Nguyen^1,2, Nhat Minh Giang¹, Duc Tan Vo³

¹Department of Intensive Cardiovascular Care and Cardiovascular Imaging, Nhan dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam.

ESC heart failure

|August 15, 2025

概括

左心室全球纵向应变 (LV-GLS) 的下降是癌症治疗相关心脏功能障碍 (CTRCD) 的最佳预测因素. 基线心力衰竭协会-国际心脏瘤学会 (HFA-ICOS) 评分没有改善接受 antracycline 或 trastuzumab 的患者的 CTRCD 预测准确性.

科学领域:

心脏瘤学 - 心脏瘤学
心血管医学心血管医学
在瘤学瘤学.

背景情况:

癌症疗法如 antracyclines 和 trastuzumab 可以导致心脏功能障碍.
早期发现与癌症治疗相关的心脏功能障碍 (CTRCD) 对患者管理至关重要.
心力衰竭协会-国际心脏瘤学会 (HFA-ICOS) 风险评分和左心室全球纵向菌株 (LV-GLS) 是CTRCD的潜在预测因素.

研究的目的:

开发一个CTRCD的预测模型.
评估基线HFA-ICOS得分和相对LV-GLS下降的综合预测值.
评估在接受 antracycline 或 trastuzumab 治疗的患者中的 CTRCD 风险.

主要方法:

预期招募443名乳腺癌和心血管风险因素的化学疗法未经治疗的妇女.
基于HFA-ICOS风险评分的患者分层.
左心室喷射率 (LVEF) 和LV-GLS的连续回声心脏学评估.
定义CTRCD是新的LVEF降低≥10个百分点到LVEF<50%.

主要成果:

同时使用的 antracycline 和 trastuzumab 治疗方案显示 CTRCD 的发病率较低 (分别为 7.2% 和 6.4%).
显著相对下降的LV-GLS>15%是CTRCD的强有力的预测者,无论是安特克林和特拉斯图祖马布治疗 (AUC0.93和0.97).
添加基线HFA-ICOS风险评分并没有改善LV-GLS下降的预测性能.

结论:

基于人环素和特拉斯图祖马布的治疗方案与CTRCD的低率有关.
连续的LV-GLS测量,特别是下降>15%,是CTRCD最有效的预测指标.
基线HFA-ICOS得分在与CTRCD预测的LV-GLS监测相结合时不会提高预后准确性.

关键词:

在LV-GLS中使用.乳腺癌乳腺癌乳腺癌与癌症治疗有关的心脏功能障碍心脏有毒性心脏有毒性化学疗法化疗化疗

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