PDF(Pubmed)
Abstract：
OBJECTIVE: Anthracycline-induced cardiotoxicity is a debilitating cardiac dysfunction for which there are no effective treatments, making early prevention of anthracycline-induced subclinical cardiotoxicity (AISC) crucial. High-density lipoprotein cholesterol (HDL-C) plays a role in cardioprotection, but its impact on AISC remains unclear. Our study aims to elucidate the protective capacity of HDL-C in AISC in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone and rituximab).
METHODS: Prospective observational study.
METHODS: Conducted in China from September 2020 to September 2022.
METHODS: 70 chemotherapy-naïve patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case-control study (DOI: 10.1186/s12885-022-10085-6).
METHODS: Serum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy.
RESULTS: 24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52±0.49 vs 1.22±0.29, p=0.034).
CONCLUSIONS: Our study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations.
BACKGROUND: Study registration number: ChiCTR2100054721.
METHODS: Prospective observational study.
METHODS: Conducted in China from September 2020 to September 2022.
METHODS: 70 chemotherapy-naïve patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case-control study (DOI: 10.1186/s12885-022-10085-6).
METHODS: Serum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy.
RESULTS: 24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52±0.49 vs 1.22±0.29, p=0.034).
CONCLUSIONS: Our study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations.
BACKGROUND: Study registration number: ChiCTR2100054721.
摘要：
目的：蒽环类药物引起的心脏毒性是一种使人衰弱的心功能不全，目前尚无有效的治疗方法，使蒽环类抗生素引起的亚临床心脏毒性（AISC）的早期预防至关重要。高密度脂蛋白胆固醇（HDL-C）在心脏保护中起作用，但其对AISC的影响尚不清楚。我们的研究旨在阐明HDL-C在AISC患者中的保护能力，这些患者患有R-CHOP治疗的弥漫性大B细胞淋巴瘤（DLBCL）（环磷酰胺，长春新碱,阿霉素,泼尼松和利妥昔单抗）。
方法：前瞻性观察性研究。
方法：于2020年9月至2022年9月在中国进行。
方法：70名新诊断为DLBCL的化疗初治患者，计划接受标准剂量的R-CHOP；60名参与者纳入病例对照研究（DOI：10.1186/s12885-022-10085-6）。
方法：血清生物标志物，二维斑点追踪超声心动图和常规超声心动图在基线测量，在R-CHOP的第三和第六周期结束时以及化疗后6和12个月。
结果：24名患者经历了AISC，10没有。36例患者失访死亡。Cox回归分析显示，较高的HDL-C水平与AISC的风险显着降低相关（未调整的HR=0.24，95％CI0.09至0.67，p=0.006；调整的HR=0.27，95％CI0.09至0.79，p=0.017）。没有AISC的患者在随访期间HDL-C水平更稳定和更高。HDL-C水平在所有患者中从第三周期化疗结束到第六周期化疗结束时显著降低(p=0.034),特别是在AISC组中(p=0.003)。没有AISC的患者HDL-C的最高水平显着高于AISC的患者（1.52±0.49vs1.22±0.29，p=0.034）。
结论：我们的研究表明，在接受R-CHOP治疗的DLBCL患者中，较高的HDL-C水平可能与较低的AISC风险相关。HDL-C可能是心脏保护靶点,但需要进一步的研究来证实其益处和局限性.
背景：研究注册号：ChiCTR2100054721。
方法：前瞻性观察性研究。
方法：于2020年9月至2022年9月在中国进行。
方法：70名新诊断为DLBCL的化疗初治患者，计划接受标准剂量的R-CHOP；60名参与者纳入病例对照研究（DOI：10.1186/s12885-022-10085-6）。
方法：血清生物标志物，二维斑点追踪超声心动图和常规超声心动图在基线测量，在R-CHOP的第三和第六周期结束时以及化疗后6和12个月。
结果：24名患者经历了AISC，10没有。36例患者失访死亡。Cox回归分析显示，较高的HDL-C水平与AISC的风险显着降低相关（未调整的HR=0.24，95％CI0.09至0.67，p=0.006；调整的HR=0.27，95％CI0.09至0.79，p=0.017）。没有AISC的患者在随访期间HDL-C水平更稳定和更高。HDL-C水平在所有患者中从第三周期化疗结束到第六周期化疗结束时显著降低(p=0.034),特别是在AISC组中(p=0.003)。没有AISC的患者HDL-C的最高水平显着高于AISC的患者（1.52±0.49vs1.22±0.29，p=0.034）。
结论：我们的研究表明，在接受R-CHOP治疗的DLBCL患者中，较高的HDL-C水平可能与较低的AISC风险相关。HDL-C可能是心脏保护靶点,但需要进一步的研究来证实其益处和局限性.
背景：研究注册号：ChiCTR2100054721。
