心脏磁共振成像对曲妥珠单抗化疗所致心脏毒性的评估

Evaluation of cardiotoxicity due to trastuzumab combined with chemotherapy by cardiac magnetic resonance imaging

目的探讨心脏磁共振成像(CMR)对乳腺癌患者曲妥珠单抗化疗后左心室容积和功能变化的评估意义。方法40例早期乳腺癌患者在基线及治疗6、12、18个月时进行CMR检查。采用线性混合模型观察这些指标的时间变化。结果与基线相比,治疗6、12个月时患者的左室舒张末期容积(LVEDV)和左室收缩末容积均增加(P<0.01),左室射血分数(LVEF)和峰值射血率(PER)/LVEDV均降低(P<0.01);治疗6、12、18个月时,峰值充盈率(PFR)/LVEDV较基线水平降低(P<0.05)。结论CMR可以检测到曲妥珠单抗联合化疗引起的左室收缩功能、舒张功能和容积的早期有害变化。

Objective To explore the significance of the value of cardiac magnetic resonance imaging(CMR)in the evaluation of left ventricular volume and function changes after trastuzumab combined with chemotherapy.Methods A total of 40 women with early breast cancer received CMR at the baseline and at 6,12 and 18 months after the treatment.The linear mixed model was used to study the changes in these indicators with the time.Results Compared with baseline data,the LVEDV and LVESV at 6 and 12 months were significantly increased(P<0.01)and LVEF and PER/LVEDV at 6 and 12 months were significantly decreased(P<0.01).Compared with baseline data,the PFR/LVEDV at 6,12 and 18 months was significantly decreased(P<0.05).Conclusion CMR can detect the early harmful changes in the left ventricular systolic function,diastolic function and volumes induced by trastuzumab combined with chemotherapy.