| Objective:To evaluate the influences of anthracycline chemotherapy on left and right ventricular function,the changes of breast cancer patients’ventricular systolic function parameters were measured by RT-3DE in each chemotherapy cycle.Methods:54 breast cancer patients undergoing chemotherapy in our hospital were selected.Using RT-3DE to examine all the selected patients before chemotherapy（T0）and after the first to sixth chemotherapy（T1～T6）,then obtained the three-dimensional volumes（LVEDV,LVESV,RVEV,RVESV）and systolic function parameters（3D-LVEF,3D-RVEF）of left and right ventricle in each chemotherapy cycle.At the same time,those parameters related to left and right ventricular inner diameter（LVIDd,LVIDs,RVd）and systolic function（LVEF,2D-LVEF,TAPSE,RV FAC,RVMPI,S’）were measured by conventional echocardiography.Serum creatine kinase isoenzyme（CK-MB）and lactate dehydrogenase（LHD）levels were measured at T0,T2,T4and T6.The differences of the above ultrasonic parameters and serum markers before and after chemotherapy were compared and analyzed.Correlations between the change of 3D-LVEF（△3D-LVEF）and that of CK-MB and LDH（△CK-MB,△LDH）were analyzed.Correlations between the changes of RT-3DE parameters（△3D-LVEF,△3D-RVEF）and that of conventional ultrasound parameters（△2D-LVEF,△TAPSE,△RV FAC,△RVMPI）before and after chemotherapy was analyzed.The correlation between△3D-RVEF and△3D-LVEF was also analyzed.Results:（1）Comparison of RT-3DE parameters of left and right ventricles before and after chemotherapy:The 3D-LVEF began to decrease at T2（62.85±3.14）%compared with T0（64.04±3.16）%,The 3D-RVEF began to decrease significantly at T3（54.72±3.96）%compared with T0（57.10±3.44）%,the differences were statistically significant（P<0.05）.LVESV,LVEDV,RVESV and RVEDV have no significant difference Compared with T0after each chemotherapy cycle（P>0.05）.（2）Comparison of left ventricle parameters by routine echocardiogram:LVIDd,LVIDs and LVEF had no significant difference before and after chemotherapy（P>0.05）;2D-LVEF decreased at T6（62.98±3.19）%compared with T0（65.42±3.31）%,and the difference was statistically significant（P<0.05）.（3）Comparison of right ventricle parameters by routine echocardiogram:TAPSE decreased significantly at T5（20.94±2.82）mm compared with T0（22.20±3.11）mm,RVMPI increased significantly at T6（0.41±0.05）compared with T0（0.36±0.06）,RV FAC decreased significantly at T5（46.93±4.85）%compared with T0（50.31±4.55）%,and the difference were statistically significant（P<0.05）.RVd and S′have no significant difference compared with T0after each chemotherapy cycle（P>0.05）.（4）Comparison of serum myocardial enzymes before and after chemotherapy:CK-MB increased at T4（16.28±5.20）U/L compared with T0（13.85±3.91）U/L,LDH increased at T4（227.32±46.27）U/L compared with T0（207.85±34.80）U/L,and the differences were statistically significant（P<0.05）.△CK-MB was positively correlated with△3D-LVEF before and after chemotherapy（r=0.44,P<0.05）.There was a correlation between△LDH and△3D-LVEF（r=0.32,P<0.05）.（5）△3D-LVEF was positively correlated with△2D-LVEF before and after chemotherapy（r=0.57,P<0.05）.△3D-RVEF was positively correlated with△TAPSE,△RV FAC and△RVMPI before and after chemotherapy,and the correlation coefficients were 0.41,0.69 and 0.51 respectively,all of which were statistically significant（P<0.05）.△3D-RVEF was positively correlated with△3D-LVEF before and after chemotherapy（r=0.80,P<0.05）.Conclusions:（1）Compared with conventional ultrasound,RT-3DE can early detect the damage of ATC to left and right ventricular systolic function in breast cancer patients.（2）RT-3DE parameters are positively correlated with serum myocardial enzymes,which can be applied clinically and provide reliable reference for timely prevention and intervention of ventricular dysfunction after chemotherapy.（3）There is a good correlation between the change of left and right ventricular systolic function parameter before and after chemotherapy. |
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