| Objection:With the utilization of conventional two-dimensional echocardiography,M-mode echocardiography,tissue Doppler imaging and real-time three-dimensional echocardiography,we explore the value of the method of using echocardiography to estimate breast cancer patients' the early changes of right ventricular function,who were after the treatment of anthracyclines chemotherapy.Methods:30 breast cancer patients hospitalized for anthracycline chemotherapy after breast surgery in our hospital were selected as the candidates of this study.Conventional two-dimensional echocardiography,m-mode echocardiography,spectral doppler echocardiography and real-time three-dimensional echocardiography(rt-3de)were performed before and after the chemotherapy.RV upper and lower diameter,RVbasal transverse diameter,RV median transverse diameter,and RV area change fraction(RVFAC)were measured by conventional two-dimensional echocardiography;Systolic displacement of tricuspid ring(TAPSE)were estimated by m-mode echocardiography;Peak flow velocity(E peak)in early tricuspid diastolic stage and peak flow velocity(A peak)in late tricuspid diastolic stage were calculated with spectral dopplertechnique;Right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV)and right ventricular ejection fraction(RVEF)were gained by real-time three-dimensional echocardiography(rt-3de).Results:1.The result of the early changes of right ventricular diameter before and after the treatment of anthracyclines chemotherapy measured by conventional two-dimensional echocardiography:The major axis of RV were 5.58±0.54cm(pre)and 5.57±0.45cm(pro);the base transverse diameter of RV were 3.15±0.40cm(pre)and 3.03±0.43cm(pro);the transverse diameter of RV were 5.57±0.45cm(pre)and 2.40±0.36cm(pro).As a result of P>0.05,There was no sufficiently significant difference of the early changes of right ventricular diameter between before and after the treatment of the chemo Sequentially,the result of tricuspid E peak and tricuspid A peak before and after the chemo measured by conventional two-dimensional echocardiography:E peak were 61.31±5.92cm/s(pre)and 61.10±5.41cm/s(pro);A peak were 58.98±5.34cm/s(pre)and 58.59±4.91cm/s(pro)(P>0.05).The result of tricuspid E peak and tricuspid A peak measured by conventional two-dimensional echocardiography.Furthermore,Cardiography with Simpson tech estimated RYFAC were 63.95±5.61%(pre)and 53.08±13.65%(pro),which had sufficiently significant difference between before and after anthracyclines chemotherapy(P<0.05).4.The price of TAPSE were 63.95±5.61%before the chemo and 53.08±13.65%after which had provoked significant decline after the chemo(P<0.05).5.The results of RVEDV and RVESV estimated by three-dimensional echocardiography were 74.51±25.00 ml(pre)and 61.32±17.21 ml(pro);33.39±22.19 ml(pre)and 25.87±8.11 ml(pro)(P>0.05).Additionally,RVEF were 66.07±5.61%(pre)and 60.81±3.63%(pro),which were of significant difference between before and after the treatment(P<0.05).2.ROC curve analysis of TAPSE,RVFAC and RVEF:the sensitivity,specificity and AUC of TAPSE value measured by m-mode echocardiography for monitoring changes in right ventricular function in the early stage of anthracycline chemotherapy were 64.72%,62.56%and 76.47%,respectively.The sensitivity,specificity and AUC of RVFAC value measured by conventional two-dimensional echocardiography to detect changes in right ventricular function in the early stage of anthracycline chemotherapy were 64.72%,62.56%and 76.47%,respectively.Real-time three-dimensional echocardiography was used to detect changes in right ventricular function in the early stage of anthracycline chemotherapy with a sensitivity of 76.47%,a specificity of 88.24%and an AUC of 0.8685(P<0.05).Conclusion:1.The RVFAC,TAPSE and RVEF of the right ventricle that measured by two-dimensional,m-mode and three-dimensional echocardiography before and after breast cancer anthracycline chemotherapy were changes significantly after chemotherapy.2.RVEF measured by real-time three-dimensional echocardiography have higher sensitivity and specificity than RVFAC and TAPSE measured by m-mode echocardiography and conventional two-dimensional echocardiography in the monitoring of early changes in right ventricular function caused by anthracycline.3.Echocardiography,especially three-dimensional technology,can be used to evaluate the changes of right ventricular function in the early stage of breast cancer anthracycline chemotherapy,can provide new enlightenment for early clinical monitoring of chemotherapy-related cardiotoxicity and effective prevention of chemotherapy-related heart diseases. |
PDF Full Text Request