PDF(Pubmed)
Abstract：
UNASSIGNED: Cardiovascular (CV) diseases are a cause of increased long-term morbidity and mortality in childhood cancer survivors (CCSs) treated with anthracyclines. These drugs may affect not only the heart, but also the vascular system. Left ventricular-arterial coupling (LVAC) represents a reliable parameter of altered ventricular and vascular performance, with validated prognostic value and never investigated in this setting. Aim of this study was to assess, in CCSs and matched controls, LVAC changes, performed with different echocardiographic modalities, and their relationship with endothelial function.
UNASSIGNED: Twenty survivors treated with anthracyclines for childhood malignancies and a matched control group of 20 healthy subjects were enrolled. Arterial elastance (Ea), end-systolic elastance (Ees), Ea/Ees ratio, as well as three-dimensional (3D) LVAC (assessed by measurement of End Systolic Volume [ESV]/Stroke Volume [SV] ratio) were performed at rest. Endothelial function was evaluated by measurement of flow-mediated dilatation (FMD) of the brachial artery.
UNASSIGNED: 3D SV and 3D ESV/SV ratio resulted respectively significantly lower and higher in CCSs than in controls, while Ea, Ees and Ea/Ees ratio were not different among groups. A positive correlation between 3D ESV/SV ratio and cumulative anthracycline doses, as well as with time after drug exposure were also found. Mean FMD was similar in CCSs and controls (8.45 ± 1.79 versus 9.41 ± 3.41, p = 0.34).
UNASSIGNED: In conclusion, conventional LVAC parameters were not shown to be significantly different between CCSs and controls; however, 3D SV and LVAC were significantly impaired in our population. In these patients, endothelial function was comparable to controls. Larger validation studies are therefore needed.
UNASSIGNED: Twenty survivors treated with anthracyclines for childhood malignancies and a matched control group of 20 healthy subjects were enrolled. Arterial elastance (Ea), end-systolic elastance (Ees), Ea/Ees ratio, as well as three-dimensional (3D) LVAC (assessed by measurement of End Systolic Volume [ESV]/Stroke Volume [SV] ratio) were performed at rest. Endothelial function was evaluated by measurement of flow-mediated dilatation (FMD) of the brachial artery.
UNASSIGNED: 3D SV and 3D ESV/SV ratio resulted respectively significantly lower and higher in CCSs than in controls, while Ea, Ees and Ea/Ees ratio were not different among groups. A positive correlation between 3D ESV/SV ratio and cumulative anthracycline doses, as well as with time after drug exposure were also found. Mean FMD was similar in CCSs and controls (8.45 ± 1.79 versus 9.41 ± 3.41, p = 0.34).
UNASSIGNED: In conclusion, conventional LVAC parameters were not shown to be significantly different between CCSs and controls; however, 3D SV and LVAC were significantly impaired in our population. In these patients, endothelial function was comparable to controls. Larger validation studies are therefore needed.
摘要：
■心血管（CV）疾病是使用蒽环类药物治疗的儿童癌症幸存者（CCS）长期发病率和死亡率增加的原因。这些药物可能不仅影响心脏，还有血管系统.左心室-动脉耦合（LVAC）代表了心室和血管性能改变的可靠参数，具有验证的预后价值，从未在这种情况下进行过调查。这项研究的目的是评估，在CCS和匹配的控件中，LVAC变化,用不同的超声心动图模式进行，以及它们与内皮功能的关系。
■纳入20名接受蒽环类药物治疗儿童恶性肿瘤的幸存者和20名健康受试者的匹配对照组。动脉弹性（Ea），收缩末期弹性(Ees)，Ea/Ees比率，以及三维（3D）LVAC（通过测量收缩末期体积[ESV]/每搏体积[SV]比率进行评估）在休息时进行。通过测量肱动脉的血流介导的扩张（FMD）来评估内皮功能。
■在CCS中，3DSV和3DESV/SV比率分别显着低于和高于对照组，而Ea,Ees和Ea/Ees比率在各组之间没有差异。3DESV/SV比值与累积蒽环类药物剂量呈正相关，以及药物暴露后的时间也被发现。CCS和对照组的平均FMD相似（8.45±1.79对9.41±3.41，p=0.34）。
■总而言之，常规LVAC参数未显示CCS和对照之间有显著差异；然而，在我们的人群中，3DSV和LVAC明显受损。在这些患者中,内皮功能与对照组相当.因此，需要进行更大规模的验证研究。
■纳入20名接受蒽环类药物治疗儿童恶性肿瘤的幸存者和20名健康受试者的匹配对照组。动脉弹性（Ea），收缩末期弹性(Ees)，Ea/Ees比率，以及三维（3D）LVAC（通过测量收缩末期体积[ESV]/每搏体积[SV]比率进行评估）在休息时进行。通过测量肱动脉的血流介导的扩张（FMD）来评估内皮功能。
■在CCS中，3DSV和3DESV/SV比率分别显着低于和高于对照组，而Ea,Ees和Ea/Ees比率在各组之间没有差异。3DESV/SV比值与累积蒽环类药物剂量呈正相关，以及药物暴露后的时间也被发现。CCS和对照组的平均FMD相似（8.45±1.79对9.41±3.41，p=0.34）。
■总而言之，常规LVAC参数未显示CCS和对照之间有显著差异；然而，在我们的人群中，3DSV和LVAC明显受损。在这些患者中,内皮功能与对照组相当.因此，需要进行更大规模的验证研究。
