Multi-parameter echocardiographic assessment of cardiac effects in breast cancer patients after chemotherapy
心脏超声多参数评估乳腺癌患者化疗后对心脏影响

摘要

目的 应用超声组织多普勒心肌应变及应变率多参数无创技术，早期评估化疗患者心肌损伤，探讨化疗对乳腺癌患者心肌的影响，通过多因素分析筛选化疗药物心脏影响的独立相关因素。方法 选取2024年1月至2025年1月宝鸡市中心医院64例女性乳腺癌化疗患者，分为化疗第3周期末（T1）、第6周期（T2），以化疗前（T0）为自身对照；记录各时期一般临床资料、常规超声心动图参数及心肌应变、应变率相关参数，比较T0与T1、T2期参数差异。结果 与T0期相比，T1、T2期LVDd、LVEF、二尖瓣E/A峰无显著差异（P＞0.05）；ε、SRs、SRe显著异常（P＜0.05），SRa无显著变化（P＞0.05）。结论 常规超声参数结合组织多普勒ε、SRs、SRe等参数，可特异性反映化疗药物心肌毒性，能更早期、可靠地为临床提供心肌损伤量化参考，助力早期心肌保护干预。

Abstract

Objective To early evaluate myocardial damage in chemotherapy patients using non-invasive multi-parameter technology of myocardial strain and strain rate by tissue Doppler echocardiography, explore the impact of chemotherapy on the myocardium of breast cancer patients, and screen independent related factors of chemotherapy drugs' cardiac effects through multivariate analysis of patients' general clinical data, conventional echocardiographic parameters and cardiac tissue Doppler parameters.
Methods A total of 64 female breast cancer patients receiving chemotherapy in Baoji Central Hospital from January 2024 to January 2025 were selected, and divided into the 3rd cycle of chemotherapy (T1) and the 6th cycle of chemotherapy (T2). The patients before chemotherapy (T0) were taken as the self-control group; general clinical data, conventional two-dimensional echocardiographic parameters, left ventricular myocardial systolic strain (ε), maximum systolic strain rate (SRs), early diastolic strain rate (SRe) and late diastolic strain rate (SRa) in each period were recorded, and the differences of each parameter between T0, T1 and T2 were measured and compared.
Results Compared with the control group, there were no significant differences in LVDd, LVEF and mitral valve E/A ratio in the chemotherapy group (P>0.05); ε, SRs and SRe were significantly abnormal (all P<0.05), and there was no significant change in SRa (P>0.05).
Conclusion   Conventional echocardiographic parameters combined with multi-parameters of tissue Doppler, including ε, SRs, SRe and other parameters, can reflect the myocardial toxicity of chemotherapy drugs with specificity, which is earlier and more reliable, provide quantitative reference for clinical early detection of myocardial damage caused by chemotherapy drugs, and help clinical early myocardial protection measures for patients receiving chemotherapy.