Left Ventricular Systolic Synchrony, Rotation And Twistionin Breast Cancer Patients Receiving Eprirubincin Using 2D-STE And RT-3DE

Objective In our country, breast cancer patients after surgery usually have to continue to receive chemotherapy, thereby can get better treatment effect. However, the anti-tumor chemotherapy can lead to some adversed effects. At present, CAF(Cyclophosphamide+adriamycin+5-fluorouracil) is the most important chemotherapy combination for breast cancer patients. But the anthracycline anti-tumor drugs could cause cardiotoxity. There are many factors influence the drug’s cardiotoxity, such as gender, age, the primary tumor’s pathological type and match type, the different delivery modes, the drug’s cumulative dose, the cardiovascular disease, combination with other anti-tumor drugs et al. The specific effect of some factors have been studyed, for example the cumulative dose, different drug delivery methods, combined wit h radiotherapy, but little research so far has dealt with the effect on cardiovascular. This experiment is aimed at this problem, use two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography, to evaluate the left ventricular rotation, twist and the systolic synchrony in breast cancer patients receiving anthracycline with different cardiac status.Methods 40 breast cancer patients after surgery receiving the chemotherapy of CAF were divided into normal group and cardiopathy group. They underwent studies in 4 stages(before chemotherapy, after the second, the forth,the sixth cycle of chemotherapy). Parasternal basal and apical short-axis images of left ventricle were recorded, and then were analyzed using QLAB software. The curves of basal and apical endo-rot, epi-rot, bulk-rot and mural-rot were obtained.Peak values of the curves were measured. And before chemotherapy and after the sixth cycle of chemotherapy, two groups were also received RT-3DE examination,the 3DQA software was used to obtain 17-segmental volume-time curves and to analyze the data of left ventricular systolic synchrony.Results 1. There were no statistically significant difference between the two groups before chemotherapy(P>0.05).2. After the second cycle of chemotherapy, the cardiopathy group’s peak values significantly increased(P<0.05), and the parts of the curve patterns were irregular. After the forth cycle of chemotherapy, the peak values increased significantly in normal group(P<0.05), and increased more significantly in cardiopathy group(P<0.01).3. Before chemotherapy, the two groups’ 17-segmental volume-time curves w e r e r e g u l a r p a r a b o l a a n d a r r a n g e i n o r d e r. A f t e r t h e s i x t h c y c l e o f chemotherapy, the two group’s curves were interlace with each other, and parts of the data of left ventricular systolic synchrony were higher than those before chemotherapy. They all increased significantly in cardiopathy group( P<0.01).Conclusion 1. The early changes of left ventricular rotation and twist in breast cancer patients receiving eprirubincin can be measured by 2D-STE. And the cardiac toxicity were significant different between cardiopathy group and normal group.2. And we also find that the left ventricular systolic synchrony was reduced in breast cancer patients receiving eprirubincin, which can be aggravated in cardiopathy group.Thus, in cardiopathy group, we need monitor more strictly of the early cardiotoxity thus guiding and adjusting clinical medication uses.