摘要
2018001 Early detection of the cardiotoxicity in-duced by chemotherapy drug through two-dimen-sional speckle tracking echocardiography combined with high-sensitive cardiac troponin T. WANG Wei（王玮）, et al. （Dept Cardiol, Renji Hosp, Shanghai Jiaotong Univ Med Sch, Shanghai 200127. ）Objective To investigate the clinical value of two- dimensional speckle tracking echocardiography （2D- STE） combined with high-sensitive cardiac troponin T （hs-cTnT） in early detection of the cardiotoxicity induced by chemotherapy drug. Methods Seventy-five non-Hodgkin＇s lymphoma patients who received the CHOP regimen were recruited in this study. Conventional echocardiography and 2D-STE were performed on these patients before chemotherapy, the second day after the third course of chemotherapy （ during chemotherapy） and the second day after the last course of chemotherapy （after chemotherapy ）. The parameters included left ventricular ejection fraction（ LVEF）, global longitudinal strain （ LS）, global circumferential strain （ CS ） and global radial strain （RS）. The serum hs-cTNT levels were tested simultaneously. Results Three cycles of CHOP were completed in 30 patients and 6 -8 cycles of CHOP were completed in 45 patients. LVEF of 75 patients before, during and after chemotherapy was （63. 8± 2.6）% ,（63.8 ±2.8）% and（64.0 ±3.3）%, respectively, without significant differences （P = 0.91 ）. However, the LS of 75 patients before, during and after chemotherapy was （ - 18.5 ±1.7）%, （ - 16.5 ± 1.9） % and （ - 16.0 ± 1.6 ） %, respectively. CS was （-20.9＋2.9）%,（ -19.3 ±3.5）% and（ -19.2± 3.2） %, respectively. RS was （ 39. 2 ± 6. 4 ） %, （ 35. 3 ± 5.2） % and （ 35.0 ± 6. 2 ） %, respectively, hs-cTnT was（0. 001 0 ± 0. 002 0） ng/ml, （0. 006 3 ± 0. 008 9） ng/ml and （ 0. 007 3 ± 0. 003 8 ） ng/ml, respectively. LS, CS and RS were significantly decreased while hs-cT- nT was significantly increased during chemotherapy when compared to those before chemotherapy （all of P 〈 0. 01）. Alternatively, LS, CS, RS and hs-cTnT after chemotherapy were marginally different from those during the chemotherapy （ all of P 〉 0. 05 ）. Moreover, TLS-SD, TCS-SD and TRS.SD showed no significant difference before,during and after chemotherapy （ all of P 〉 0. 05 ）. The reduction of LS was positively associated with the enhancement of hs-cTnT after chemotherapy （r = 0.60, P 〈 0. 01 ）. Conclusion 2D-STE combined with hs-cTnT can effectively and precisely detect the occult cardiotoxicity induced by anthracycline.
