早期心电图复极变化与淋巴瘤患者的亚临床癌症治疗相关的心脏功能障碍有关:一项机器学习辅助的纵向研究
Muhsin Sarıhan1, Mürsel Şahin2, Ali Nail Kaya3
1Department of Cardiology, Şebinkarahisar State Hospital, Bülbül Mahallesi, 28400 Şebinkarahisar, Giresun, Türkiye.
Journal of electrocardiology
|March 10, 2026
概括
doxorubicin 化疗会导致早期的心电图再极化变化,如纠正的 JT 间隔 (JTc) 延长,这在心脏功能障碍之前发生. 这些心电图标记,特别是JTc和纠正的QT分散 (QTcd),与癌症患者的亚临床心脏功能障碍有关.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 生物医学工程 生物医学工程
背景情况:
- 人环素诱导的心脏毒性是癌症幸存者的重大临床问题.
- 全球纵向菌株 (GLS) 检测到早期心肌功能障碍,但化学疗法期间的ECG再极化变化尚未完全理解.
研究的目的:
- 为了分析 doxorubicin 治疗期间 ECG 纵向再极化变化.
- 使用机器学习识别与亚临床癌症治疗相关的心脏功能障碍 (CTRCD) 相关的关键心电图标记.
主要方法:
- 对36名接受基于多克索鲁比的化疗的淋巴瘤患者的回顾性分析.
- 评估了连续的12导电心电图,心声回声 (LVEF,GLS) 和心脏生物标志物.
- 探索性随机森林分析优先考虑了与GLS变化相关的ECG再极化参数.
主要成果:
- 通过第二个周期显著延长纠正的QT,纠正的JT间隔 (JTc) 和T-峰到T-结束间隔.
- 从第四个周期开始增加了QT分散和纠正了QT分散.
- 化疗后减少GLS,而LVEF保持; ΔJTc和ΔQTcd与GLS减少最相关.
结论:
- 德克索鲁比辛在化疗早期诱导腹腔再极化异常,先于心功能障碍.
- JTc和QTcd是与亚临床CTRCD相关的优先级心电图标记.
- 复极化的心电图监测为早期心脏毒性检测提供了一个具有成本效益的补充.
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