Changes and clinical significance of serum myocardial markers and echocardiography in patients with breast cancer undergoing anthracycline chemotherapy
Objective To investigate the changes of serum myocardial markers and cardiac ultra-sound in patients with anthracycline chemotherapy for breast cancer,and to analyze their clinical signifi-cance.Methods A total of 124 breast cancer patients admitted to Shanxi Cancer Hospital from April 2020 to April 2023 were included.All patients received anthracycline chemotherapy.Serum troponin Ⅰ(cTn Ⅰ),creatine phosphokinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),α-hydroxybutyrate dehydro-genase(α-HBDH)levels and cardiac ultrasound indexes were compared before chemotherapy(T0),after 2 cycles of chemotherapy(T1),and after 4 cycles of chemotherapy(T2).The echocardiographic parameters included left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(ESVI),and left ventricular end-diastolic volume index(EDVI).After 6 months of follow-up,patients were divided into impaired group(n=33)and non-impaired group(n=91)according to whether there was cardiotoxic dam-age after chemotherapy.Myocardial markers and ultrasound parameters before and after chemotherapy were compared between the two groups.Results The levels of cTn Ⅰ,CK-MB,LDH,α-HBDH in breast cancer patients at T1 and T2 were[0.54±0.10 and(0.67±0.23)μg/L;11.40±2.52and(15.26± 3.89)U/L;143.13±24.08 and(166.31±49.47)U/L;117.43±27.80 and(134.01±45.69)U/L],higher than T0[(0.45±0.07)μg/L,(9.03±1.65)U/L,(129.44±21.16)U/L,(100.22± 17.31)U/L].The level of each index at T2 was higher than that at T1(F=69.371,152.010,37.170,33.609,P＜0.05).The E/e'at T1 and T2(6.97±0.38,7.10±0.25)was higher than that at T0(6.71±0.80),and that at T2 was higher than that at T1(F=17.922,P＜0.05).The incidence of cardiac toxicity and side effects in 124 patients with breast cancer was 26.61％(33/124).The comparison of cTnⅠ,CK-MB,LDH and α-HBDH between the impaired group and the non-impaired group showed that there were temporal differences,inter-group differences,and interaction effects(Ftime=263.600,175.000,76.370,175.000,Ptime＜0.05;Famong groups=482.000,478.900,206.300,473.900,Pamong groups＜0.05;Finteraction=198.000,157.300,65.710,150.400,Pinteraction＜0.05).The levels of cTnⅠ,CK-MB,LDH and α-HBDH at T1 and T2 were higher than those at T0,and those in the impaired group were higher than those in the non-impaired group(F=65.124,29.546,65.214,89.578,25.236,98.256,125.214,36.690,P＜0.05).The E/e'values at T0,T1 and T2 were 6.73±0.78,7.25±0.15,7.35±0.10 and 6.70±0.81,6.87±0.39,7.01±0.22,respectively.The results showed that the E/e'at T1 and T2 was higher than that at T0,and that in the impaired group was higher than that in the non-impaired group(F=10.987,16.325,P＜0.05).Conclusion Patients with anthracycline chemotherapy for breast cancer have shown changes in myocardial markers and E/e'in the early stage of chemotherapy.These parameters are expected to evaluate the risk of cardiac toxicity in patients with anthracycline.
Breast cancerAnthracyclinesChemotherapyCardiac ultrasoundMyocardial marker
NETL
NSTL
万方数据
