未经证实:早期发现免疫检查点抑制剂(ICI)治疗的亚临床心脏毒性可能具有挑战性。
UNASSIGNED:使用二维斑点追踪成像(2D-STI)和三维超声心动图评估中国患者的亚临床心功能不全。
UNASSIGNED:纳入了55例接受免疫治疗的恶性肿瘤患者。在免疫治疗前和免疫治疗后进行超声心动图检查。三维成像计算左心室射血分数(LVEF)。此外,左心室整体纵向峰值收缩应变(LVGLS),左心室全周收缩峰值应变(LVGCS),右心室整体纵向收缩应变(RVGLS),右心室游离壁纵向峰值收缩应变(RVFWLS),评估三尖瓣环平面收缩期偏移(TAPSE)。记录临床和实验室参数。心脏毒性事件定义为存在心力衰竭症状,LVEF降低,并增加肌钙蛋白。亚临床心脏毒性定义为与ICI治疗相关的心功能不全。与ICI相关的心脏毒性临床症状缺失或延迟。
UNASSIGNED:与基线相比,LVGLS,TAPSE,ICI治疗后RVGLS显著恶化[(-18.63±2.53)%vs.(-17.35±2.58)%,P=0.000;18.29±6.23vs.14.57±3.81,P=0.0001;和(-18.45±4.65)%vs.(-14.98±3.85)%,分别为P=0.0001]。LVGLS(-17.35±2.58,P=0.000),TAPSE(14.57±3.81,P=0.0001),和RVGLS[(-14.98±3.85)%,P=0.0001]在ICI免疫治疗后降低。Kaplan-Meier曲线分析显示,LVGLS比心脏毒性事件更敏感地评估ICI相关的亚临床心功能不全(log-rankP=0.205)。ROC曲线显示ΔLVGLS的截止值为-13%。
UNASSIGNED:可以使用二维斑点追踪成像来检测亚临床心脏功能障碍。LVGLS,RVGLS,和TAPSE是更敏感的检测指标。
UNASSIGNED:[https://www.chictr.org.cn/showprojen.aspx?proj=27498],标识符[ChiCTR1800016216]。
UNASSIGNED: Early detection of subclinical cardiotoxicity of immune checkpoint inhibitor (ICI) therapy can be challenging.
UNASSIGNED: To evaluate subclinical cardiac dysfunction using two-dimensional speckle tracking imaging (2D-STI) and three-dimensional echocardiography in Chinese patients.
UNASSIGNED: Fifty-five consecutive patients with malignant tumors treated by immunotherapy were included. They were examined by echocardiography before immunotherapy and after immunotherapy. Left ventricular ejection fraction (LVEF) was calculated in three-dimensional imaging. Moreover, left ventricular global longitudinal peak systolic strain (LVGLS), left ventricular global circumferential peak systolic strain (LVGCS), right ventricular global longitudinal systolic strain (RVGLS), right ventricular free wall longitudinal peak systolic strain (RVFWLS), and tricuspid annular plane systolic excursion (TAPSE) were evaluated. Clinical and laboratory parameters were recorded. Cardiac toxicity events were defined as the presence of heart failure symptoms, LVEF reduction, and increase in troponin. Subclinical cardiac toxicity was defined as cardiac dysfunction associated with ICI treatment, with absent or delayed ICI-associated cardiotoxicity clinical symptoms.
UNASSIGNED: Compared with baseline, the LVGLS, TAPSE, and RVGLS significantly deteriorated after ICI treatment [(-18.63 ± 2.53)% vs. (-17.35 ± 2.58)%, P = 0.000; 18.29 ± 6.23 vs. 14.57 ± 3.81, P = 0.0001; and (-18.45 ± 4.65)% vs. (-14.98 ± 3.85)%, P = 0.0001, respectively]. LVGLS (-17.35 ± 2.58, P = 0.000), TAPSE (14.57 ± 3.81, P = 0.0001), and RVGLS [(-14.98 ± 3.85)%, P = 0.0001] were decreased after ICI immunotherapy. Kaplan-Meier curve analysis showed that LVGLS was more sensitive than the cardiac toxicity events to assess ICI-related subclinical cardiac dysfunction (log-rank P = 0.205). The ROC curve showed that the cutoff value of ΔLVGLS was -13%.
UNASSIGNED: Subclinical cardiac dysfunction can be detected using two-dimensional speckle-tracking imaging. LVGLS, RVGLS, and TAPSE are more sensitive indices for detection.
UNASSIGNED: [https://www.chictr.org.cn/showprojen.aspx?proj=27498], identifier [ChiCTR1800016216].