[an error occurred while processing this directive] | [an error occurred while processing this directive]
Two-dimensional speckle tracking imaging in assessing the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy
Yang Fei1, Chen Yong1, Chen Yong2, Yu Haidi1, Liu Min2
1. Department of Echocardiography,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou 225001,China;2. Department of Oncology,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou 225001,China
AbstractObjective To evaluate the early injury and dynamic changes of the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy by using two-dimensional speckle tracking imaging (2D-STI). Methods From 2017 to 2018,echocardiography examinations were performed in 39 patients with esophageal carcinoma before, during and after the first thoracic radiotherapy to measure the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LVEF),early diastolic mitral flow velocity/early diastolic mitral annular peak velocity (E/e′),left atrial volume (LAV),2D-STI parameters including the left ventricular global longitudinal strain (GLS),global systolic stain rate (GSRs),global early diastolic strain rate (GSRe),global late diastolic strain rate (GSRa) and E/GSRe ratio. According to the GLS of patients with esophageal carcinoma after radiotherapy (cumulative dose≥50 Gy),the patients were divided into good prognosis (n=23) and poor prognosis groups (n=16). The E/GSRe ratio was statistically compared between two groups. Results The E/e′and LAVI were increased significantly only after radiotherapy (both P<0.05),and LVEF was decreased significantly only after radiotherapy (P<0.05). The e′ tended to decline before, during and after radiotherapy (all P<0.05).GLS and GSRs were significantly decreased only after radiotherapy (both P<0.05), whereas GSRa was considerably decreased during radiotherapy (P<0.05).E/GSRe tended to increase (P<0.05). Compared with the good prognosis group, E/GSRe was significantly increased after radiotherapy in the poor prognosis group (P<0.05). Conclusions Diastolic dysfunction can occur in the early stage of radiation-induced heart injury. The global diastolic strain rate and E/GSRe obtained by 2D-STI can be used to assess the early left ventricular dysfunction. E/GSRe can be more sensitive to evaluate the clinical prognosis compared with the global diastolic strain rate.
Yang Fei,Chen Yong,Chen Yong et al. Two-dimensional speckle tracking imaging in assessing the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(5): 344-348.
Yang Fei,Chen Yong,Chen Yong et al. Two-dimensional speckle tracking imaging in assessing the left ventricular diastolic function of patients with esophageal carcinoma after radiotherapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(5): 344-348.
[1] Skytta T,Tuohinen S,Boman E,et al. Troponin T-release associates with cardiac radiation does during adjuvant left-sided breast cancer radiotherapy[J].Radiat Oncol,2015,10(10):141-148.DOI:10.1186/s13014-015-0436-2. [2] 赵志玉,陈金玲,周青,等.心肌纵向分层应变参数评价冠心病患者左心室局部及整体收缩功能[J].中华超声影像学杂志,2016,25(1):1-6.DOI:10.3760/cma.j.issn.1004-4477.2016.01.001. Zhao ZY,Chen JY,Zhou Q,et al. Evaluation of left ventricular local and integral contractile function in patients with coronary heart disease by longitudinal stratified strain parameters of myocardium[J].Chin J Ultras Imag,2016,25(1):1-6.DOI:10.3760/cma.j.issn.1004-4477.2016.01.001. [3] Sritharan HP,Delaney GP,Queenie L,et al. Evaluation of traditional and novel echocardiographic methods of cardiacdiastolic dysfunction post radiotherapy in breast cancer[J].Int J Cardiol,2017,243(2):204-208.DOI:10.1016/j.ijcard.2017.05.007. [4] Lo Q,Hee L,Batumalai V,et al. Subclinical cardiac dysfunction detected by strain imaging during breast irradiation with persistent changes 6 weeks after treatment[J].Int J Radiat Oncol Biol Phys,2015,92(2):268-276.DOI:10.1016/j.ijrobp.2014.11.016 [5] Petek BJ,Greenman C,Herrmann J,et al. Cardio-oncology:an ongoing evolution[J].Future Oncol,2015,11(14):2059-2066.DOI:org/10.2217/fon.15.89. [6] 姚晔,钟亚华,谢丛华.放射性心脏损伤心肌纤维化发病机制研究进展[J].中华放射肿瘤学杂志,2017,26(5):598-602.DOI:10.3760/cma.j.issn.1004-4221.2017.05.026. Yao Y,Zhong YH,Xie CH.Research progress on pathogenesis of myocardial fibrosis in radioactive heart injury[J].Chin J Radiat Oncol,2017,26(5):598-602.DOI:10.3760/cma.j.issn.1004-4221.2017.05.026. [7] Boerma M,Wang JR,Sridharan V,et al. Pharmacological induction of transforming growth factor-betal in rat models enhances radiation injury in the intestine and the heart[J/OL].PLoS One,2013,8(7):e70479.DOI:10.1371/ journal pone.0070479. [8] Sridharan V,Sharma SK,Moros EG,et al. Effects of radiation on the epidermal growth factor receptor pathway in the heart[J].Int J Radiat Biol,2013,89(7):539-547.DOI:10.3109/09553002.2013.782110. [9] Nagueh SF,Smiseth OA,Appleton CP,et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography:an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J].Eur Heart J Cardio Imag,2016,17(12):1321-1360.DOI:10.1093/ehjci/jew082. [10] Boyd A,Stoodley P,Richards D,et al. Anthracyclines induce early changes in left ventricular systolic and diastolic function:a single centre study[J/OL].PLoS ONE,2017,12(4):1-15.DOI:10.1371/journal.pone.0175544. [11] Groarke JD,Nguyen PL,Nohria A,et al. Cardiovascular complications of radiation therapy for thoracic malignancies:the role for non-invasive imaging for detection of cardiovascular disease[J].Eur Heart J,2014,35(10):612-623.DOI:org/10.1093/eurheartj/eht114. [12] Ersboll M, Andersen MJ, Valeur N, et al. Early diastolic strain rate in relation to systolic and diastolic function and prognosis in acute myocardial infarction;a two-dimensional speckle-tracking study[J].Eur Heart J,2014,35(10):648-656.DOI:10.1093/eurheartj/eht179. [13] Charbonnel C,Convers-Domart R,Rigaudeau S,et al. Assessment of global longitudinal strain at low-does anthracycline-based chemotherapy,for the prediction of subsequent cardiotoxicity[J].Eur Heart Imag,2017,18(2):392-401.DOI:10.1093/ehjci/jew223. [14] 陈偲晔,王淑莲,唐玉,等.左侧乳腺癌保乳术后采用深吸气屏气放疗的心脏剂量学分析[J].中华放射肿瘤学杂志,2018,27(3):281-288.DOI:10.3760/cma.j.issn.1004-4221.2018.03.011. Chen SY,Wang SL,Tang Y,et al. Cardiac dosimetry analysis of deep inhale and breath radiotherapy after breast cancer preservation in the left[J].Chin J Radiat Oncol, 2018,27(3):281-288.DOI:10.3760/cma.j.issn.1004-4221.2018.03.011.
2019, Vol. 28 
