Study On The Evaluation Value Of Myocardial Injury Index Combined With Electrocardiogram In Early Radiation-induced Heart Disease Of Chest Tumor

Objective:To investigate the evaluation value ofmyocardial injury index combined with electrocardiogram in the early radiation-induced heart disease of chest tumors.Methods:97patients with chest malignant tumors who received radiotherapy for the first time from November 2020 to September 2021 in the Department of Oncology Radiotherapy of our hospital were selected for the study.Patientsunderwent high-sensitivity troponin T,creatine kinase isoenzyme,myoglobin,and electrocardiogram tests before radiotherapy,after40 GYradiotherapy,after 50 GY radiotherapy,and after60 GY radiotherapy,respectively.The symptoms and myocardial injury index findings of all patients with radiation cardiac injury were described and graded according to the common adverse events criteria(CTCAE version 5.0);all patients with radiation cardiac injury were graded according to the acute radiation injury grading criteria(RTOG).The above results were statistically analyzed to explore theevaluation value of myocardial injury index combined with electrocardiogram in the early radiation-induced heart disease of chest tumors.Results:In this study,patients had sinus tachycardia,left ventricular hypertrophy or high voltage,ST-T changes,T-wave changes,electrical axis deviation and other electrocardiogram changes.Among them,sinus tachycardia,left ventricular hypertrophy or high voltage and ST-T changes were the most common.27 patients with RIHD grade 1(27.8%)and 4 patients with RIHD grade 2(4.1%),and there was no RIHD grade 3 and 4 in this study.Compared with before radiotherapy,the levels of hsTnT,CK-MB and MYO were all increased at 40GY,50GY and 60GY after radiotherapy.The increase of hsTnT was not statistically significant(P>0.001),while the increase of CK-MB and MYO was statistically significant(P<0.001).The detection rate,sensitivity and negative predictive value of myocardial injury index combined with electrocardiogram for RIHD were higher than those of any single detection.There were no differences in age,gender,history of hypertension,history of previous chemotherapy,radiation dose and lung irradiated volume V20 between RIHD group and non-RIHD group.There were statistically significant differences in GTV volume,cardiac Dmean,cardiac volume V30 and cardiac volume V40.The above indexes in RIHD group were significantly higher than those in non-RIHD group(P<0.05).Conclusion:1.Electrocardiogram changes are a common phenomenon in patients with chest tumors during radiotherapy,and plasmahigh-sensitivity troponin T,creatine kinase isoenzyme,and myoglobin increase with the extension of radiotherapy time.2.Myocardial injury index combined with electrocardiogram detection can improve the detection rate of RIHD,and it isless invasiveand easy to operate,which has important evaluation value for early radiation heart injury of chest tumor.3.Early radiation-induced heart disease in chest tumors is related to tumor volume,average cardiac dose,and irradiated volume.