Value of Myocardial Strain in Monitoring Fluorouracil-Based Chemotherapy-Related Cardiac Dysfunction in Gastrointestinal Cancer Patients  

作　　者：Wei Yang Jian-Xia Yang Jing-Yuan Guan Wu-Yun Bao Mei Zhang 

机构地区：[1]State Key Laboratory for Innovation and Transformation of Luobing Theory,Key Laboratory of Cardiovascular Remodeling and Function Research,Chinese Ministry of Education,Chinese National Health Commission and Chinese Academy of Medical Sciences,Department of Cardiology,Qilu Hospital of Shandong University,Jinan 250012,China [2]Department of Gastroenterology,Qilu Hospital of Shandong University,Jinan 250012,China

出　　处：《Chinese Medical Sciences Journal》2024年第4期273-281,共9页中国医学科学杂志（英文版）

摘　　要：Objective To investigate the predictive value of myocardial strain for cardiotoxicity associated with fluorouracil-based chemotherapies in gastrointestinal cancer patients.Methods Patients with diagnosis of gastrointestinal cancers,who were hospitalized for chemotherapy involving antimetabolic drugs,were eligible in this prospective study.Echocardiography was performed before and after each chemotherapy cycle during hospitalization until the completion of chemotherapy.Cancer therapy-related cardiac dysfunction(CTRCD)was identified if there was a decrease in left ventricular ejection fraction(LVEF)by at least 5%to an absolute value of<53%from the baseline,accompanied by symptoms or signs of heart failure;or a decrease in LVEF of at least 10%to an absolute value of<53%from the baseline,without symptoms or signs of heart failure.Subclinical cardiac impairment is defined as a decrease in the left ventricular global longitudinal strain(GLS)of at least 15%from baseline.Clinical data and myocardial strain variables were collected.Changes of echocardiographic indexes after chemotherapy at each cycle were observed and compared to those of pre-chemotherapy.Cox regression analysis was used to determine the associated indexes to CTRCD,and receiver operating characteristic(ROC)curves were plotted for evaluation of their predicting efficacy.Results Fifty-one patients completed 4 cycles of chemotherapy and were enrolled in the study analysis.LVEF,GLS,GLS epicardium(GLS-epi),and GLS endocardium(GLS-endo)were decreased after the 4 cycles of chemotherapy.Throughout the chemotherapy period,6 patients(11.8%)progressed to CTRCD.The Cox regression analysis revealed that the change in left atrial ejection fraction(LAEF)and LAS during the reservoir(LASr)phase after the first cycle of chemotherapy(C1v-LAEF and C1v-LASr,respectively)were significantly associated with the development of CTRCD[C1v-LAEF(HR=1.040;95%CI:1.000-1.082;P=0.047);C1v-LASr(HR=1.024;95%CI:1.000-1.048;P=0.048)].The sensitivity and specificity were 50.0%and 93.3%,respec

关 键 词：fluorouracil cardiovascular toxicity ECHOCARDIOGRAPHY speckle tracking imaging technique myocardial work myocardial strain 

分 类 号：R735[医药卫生—肿瘤]