Detecting Heart Damage Induced By Thoracic Radiotherapy By Echocardiography And It's New Techniques

Objective To explore the clinical value of echocardiography, acoustic densitometry(AD) and tissue Doppler imaging(TDI) in assessing heart damage induced by chest radiotherapy in patients with thoracic tumors.Methods 120 patients(those patients were devided into three group: â…  group-radiotherapy simply;â…¡ group-radiotherapy combined with Anthracyclines;â…¢group-radiotherapy combined with other chemotherapeutic drugs.) received chest radiotherapy were examined by echocardiography, acoustic densitometry and tissue Doppler imaging before radiotherapy and six months later. Besides the routine echocardiography parameters, integrated backscatter(IBS),cyclic variation of IBS(CVIB),normalized IBS (IBS%) and normalized cyclic variation of IBS (CVIB%) of inter-ventricle septum and left ventricle posterior wall were obtained at parasternal long axis view ,while the peak motion velocity during systolic period ,early diastolic period and atrial contraction period of mitral annulus tricuspid annulus and right ventricle free wall were detected from apical four chamber view.29 healthy person were enrolled as control group.Results Some abnormal echocardiography characters appeared in 15 subjects among 120 patients after chest radiotherapy (12.5%). such as pericardial effusion, thicking of pericardial wall, thicking of heart valve , valvular regurgitation, while regression of diastolic function of left ventricle appeared in 34 patients(28.3%) and heightening of pulmonary artery systolic pressure appeared in 2 patients. AD shows: IBS and IBS% was significantly high while CVIB and CVIB% were significantly low compared with those data obtained before irradiation. TDI shows : after radiotherapy, the peak motion velocity during systolic period and early diastolic period of mitral annulus ,tricuspid annulus and right ventricle free wall decreased ,while the peak velocity during atria contraction period increased . Among patients received radiotherapy combined with Anthracyclines treatment ,the changes of parameters acquired from AD and TDI differed significantly from those patients treated by simplex irradiation or radiotherapy combined with other chemotherapeutic drugs. At the same time, those data in patients received radiotherapy combined with other chemotherapeutic drugs differed significantly from those patients treated by simplex irradiation .As to the control group, all of the parameters changed insignificantly six month later.Conclusions Echocardiography, AD and TDI can be used in assessing early heart damage inducedby chest radiotherapy. Compared with echocardiography, AD and TDI are more sensitive in detectingmicrocosmic changes and abnormalities of heart function. Radiotherapy combined with Anthracyclines or other chemotherapeutic drugs can aggravate heart damage.