The Value Of Three-dimensional Spot Tracking Imaging Technology In Grading The Impact Of Myocardial Systolic Function In Patients With Lung Cancer Received Chemotherapy

Objective The incidence of primary lung cancer has increased remarkably in recent years,and has become the most common malignant tumor in China.Non-small cell lung cancers account for 75% to 80%.Some data have revealed that more than half of the patients has suffered from distant metastasis in the first diagnosis of luncer cancer,so the treatment and diagnosis of patients with terminal lung cancer plays an important role.The comprehensive plan of treatment,which is based on systemic treatment,is adopted in the treatment of terminal lung cancer,and chemotherapy is one of the major methods.The side effects of chemotherapy has limited its clinical use and also have done harm to the patients.Pemetrexed combined with cisplatin is the commonly used chemotherapy clinically,but the chemotherapy has increased the risk of angiocardiopathy.This study was to explore the value of three-dimensional speck trackingimaging(3D-STI)in evaluating myocardial damage of chemotherapy with pemetrexed combined with cisplatin to patients with non-small cell lung cancer.Methods 38 NSCLC patients(22 females,16 males)using chemotherapy with pemetrexed combined with cisplatin were selected and tracked,and the average age of them were 42 to 77 years old(59.1±7.3).There was an interval of 21 days,and there were 6 terms in every chemotherapy.The satge was divided into prechemotheapy,3cycles postchemotheapy and 6cycles postchemotheapy.The parameters of electrocardiogram,conventional echocardiography,TDI and 3D-STI were measured in every stage,and each parameter was the average of 3 cardiac cycles.The receiver operating characteristics(ROC)curve was constructed to determine the accuracy of parameters of 3D-STI(GAS?GCS?GLS?GRS)and TDI(Em?Am?Em/Am?Sm?E/Em)in detecing myocardial damage.Delong was applied to compare the difference of AUC of different parameters.Results 1.There was no significant difference between parameters in three groups of conventional echocardiography.2.Em and Em/Am were significantly lower in and 6cycles postchemotheapy compared with prechemotheapy,3cycles postchemotheapy(P<0.05).3.There was significance among GAS,GCS and GLS in three groups(P<0.05).There existed no significance of GRS in prechemotheapy and postchemotheapy.There was statistical significance of GAS and GLS in three groups(P<0.05),while there was statistical significance of GLS between group C and group A,B.(P<0.05).4.The areas under the curve of GAS,GLS,GCS and GRS are 0.929,0.707,0.654 and 0.563 respectively,and both areas under the curve of GAS and GLS are over 0.7.The optimal cut-off value of every parameter was acquired by Youden index.The optimal cut-off value of GAS evaluating myocardial damage was-30.5%,with a specificity of 88.2% and sensitivity of 81.6%.The optimal cut-off value of GAS evaluating myocardial damage was-17.5%,with a specificity of 71.1% and sensitivity of 60.5%.The areas under the curve of Em,Am,Sm,Em/Am,E/Am are 0.698,0.405,0.555,0.813 and 0.408 respectively,and the area under the curve of Em/Am was over 0.7.The optimal cut-off value of every parameter was acquired by Youden index.The optimal cut-off value of Em/Am evaluating myocardial damage was 1.060,with a specificity of 92.1% and sensitivity of 52.6%.5.The difference of AUC between GAS and Em/Am was compared by the method of De Long,and it showed statistical significance.Conclusion Strain parameters acquired by 3D-STI can early detect myocardial damage in lung cancer patients receiving chemotherapy with pemetrexed combined with cisplatin.ROC has revealed that GAS has a high specificity and sensitivity in detection of leftventricular myocardial dysfunction.3D-STI could provide important information about myocardial dysfunction for patients.