Clinical And Experimental Study Of Radiation-induced Cardiac Injury

Objective:To investigate the physical,clinical and ethnic factors associated with acute RIHD in patients with left breast cancer after radiotherapy at high altitude,to provide evidence for clinical individualized radiotherapy.To explore the protective effect of salidroside on RIHD mice by studying the application of Salidroside in RIHD mice model.Methods:Analysis of the effect of dose volume parameters of cardiac and left ventricle and clinical factors on acute RIHD.And analysis of the relationship between different chemotherapy regimens,nationalities and the occurrence of acute RIHD.Logistic analysis was used to analyze the independent influencing factors.The establishment of RIHD mice model,analysis of the effect of salidroside on growth and development of mice,expression of bcl-2/bax and histopathological changes of myocardium.Result:74 patients with left breast cancer who underwent radiotherapy were analyzed.The common terminology of adverse reactions 3.0 of the National Cancer Institute was used to evaluate and classify acute radiation-induced cardiac injury.The incidence of acute RIHD in all patients was analyzed,and the relationship between dose volume parameters and clinical factors of heart and left ventricle and the occurrence of acute RIHD was analyzed.The relationship between TAC regimen and AC-T regimen and acute RIHD in different nationalities was also analyzed.Logistic regression analysis was used to analyze the independent influencing factors of the different factors.48 patients suffered from acute radiation-induced cardiac injury?64.8%?.The patients were divided into two groups according to whether there was cardiac injury or not.The MHD and V₄₀ in the non-cardiac injury group were lower than those in the cardiac injury group?t=-1.988,-5.435,P=0.049,<0.001?;the Dmean dose of the left ventricle in the non-injury group was lower than that in the injury group?t=2.367,8.063,9.000?.093;P=0.047,<0.001,<0.001);there was significant difference between the two groups in clinical factors??²=5.466,P=0.029?.Fisher's exact probability method showed that there was no significant difference between TAC regimen and AC-T regimen in the incidence of acute RIHD?P=0.670?;among different nationalities,the incidence of Han?69.6%?was significantly higher than that of Tibetan?52.4%?,but there was no significant difference between them??²=1.852,P=0.272?;Logic was applied to the factors with statistical differences.The correlation between cardiac V₄₀,left ventricular V₄₀,combined chemotherapy and acute RIHD was significant by Tic regression analysis?P<0.001,=0.004,=0.008?.The growth of mice was inhibited after irradiation,and the effect of high dose radiation on mice was more serious.The body weight of salidroside intervention group was slightly higher than that of simple irradiation group at the same dose.The body weight of 20 Gy+intervention group was significantly different from that of 20Gy group 4 weeks after irradiation?P<0.05?.Salidroside could reduce the effect of RIHD on the growth and development of mice.Inflammatory pathological changes were observed in all experimental groups.The inflammation reaction in 20Gy group was more severe than that in other experimental groups.The inflammation reaction in heart tissue of mice after salidroside intervention was less than that in the non-intervention group.Conclusion:Control the volume of cardiac V₄₀ to less than 6.5%,and to prevent patients combined with chemotherapy as early as possible can reduce the risk of acute RIHD in patients.Salidroside has protective effect on the heart of RIHD mice.This study can provide clinical reference for the prevention and treatment of RIHD by salidroside.