The value of echocardiography combined with serum cTnⅠ and GDF-15 in the evaluation of cardiac injury in elderly patients with breast cancer after chemotherapy
Objective To explore the value of echocardiography combined with serum cardiac troponin Ⅰ(cTnⅠ)and growth differentiation factor-15(GDF-15)in evaluating cardiac injury after chemotherapy in elderly patients with breast cancer(BC).Methods A total of 112 elderly BC patients who received epirubicin based chemotherapy from September 2019 to August 2022 in Beijing Daxing District People's Hospital were selected as the research objects,and they were divided into heart injury group(40 cases)and non heart injury group(72 cases)according to whether heart injury oc-curred.The diagnostic value of echocardiography in elderly BC patients with postoperative chemotherapy heart injury was evaluated;the levels of serum cTnⅠ and GDF-15 were detected by enzyme-linked immunosorbent assay;receiver op-erating characteristic curve was used to evaluate the diagnostic value of serum cTnⅠ and GDF-15 in elderly BC patients with postoperative chemotherapy induced cardiac injury.The diagnostic criteria for cardiotoxicity was used as the gold standard,and the diagnostic value of echocardiography,serum cTnⅠ,GDF-15 and their combination in elderly BC pa-tients with postoperative chemotherapy heart injury was analyzed.Results The sensitivity,specificity and accuracy of echocardiography in the diagnosis of postoperative cardiac injury after chemotherapy in elderly BC patients were 77.50％,88.89％and 84.82％,respectively;the levels of serum cTnⅠ and GDF-15 in heart injury group were signifi-cantly higher than those in non heart injury group(P＜0.05);the area under curve of serum cTnⅠ and GDF-15 in the di-agnosis of cardiac injury after postoperative chemotherapy in elderly patients with BC were 0.864 and 0.834,the cut-off values were 221.88 ng/L and 8.06 ng/L,the sensitivity were 75.00％and 80.00％,the specificity were 94.44％and 87.50％,the accuracy were 87.50％and 84.82％,respectively;the sensitivity,specificity and accuracy of echocardio-graphy combined with serum cTnⅠ and GDF-15 in the diagnosis of cardiac injury after chemotherapy in elderly patients with BC were 97.50％,86.11％and 90.18％,respectively,which were better than that of single diagnosis.Conclusion Echocardiography combined with serum cTnⅠ and GDF-15 has high diagnostic value for cardiac injury caused by post-operative chemotherapy in elderly BC patients,which can effectively improve the sensitivity,accuracy and has high spe-cificity.
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