The Clinical Study Of Cardiotoxicity Associated With Anthracyclines In Patients With Lymphoma

Objective To explore the occurrence and clinical characteristics of cardiotoxicity in lymphoma patients treated with anthracycline chemotherapy,and to explore the risk factors of cardiotoxicity in lymphoma patients treated with anthracycline chemotherapy,and to further analyze the diagnostic value of hypersensitive cardiac troponin T(hs-c Tn T)and abnormal times of ECG in cardiotoxicity during chemotherapy.Methods The electronic medical record system of Gansu Provincial Hospital from January2016 to October 2022 was retrospectively collected from 251 patients who were diagnosed as lymphoma by pathological biopsy in the Department of Oncology and Hematology and who met the criteria of Naturalization,and were divided into cardiac toxicity group(n=51)and noncardiac toxicity group(n=200)according to whether cardiac toxicity occurred after chemotherapy.Collect the baseline data,myocardial enzymology indexes and biochemical indexes of the enrolled patients,and explore the factors that may cause cardiotoxicity through binary logistic regression.The diagnostic value of hs-c Tn T and the number of ECG abnormalities in cardiotoxicity was further analyzed by using the subject working curve(ROC).Results(1)There were 125 cases of cardiotoxicity,that is,abnormal ECG,with an incidence of 49.8%.The most important abnormal ECG was ST-T change,with an incidence of 48.6%.(2)There were 51 cases of cardiotoxicity,with an incidence of 20.31%.(3)Multivariate logistic regression analysis of cardiotoxicity showed that age,sex,the number of ECG abnormalities ≥ 5 times,the cumulative dose of anthracycline drugs,and the abnormality of hs-c Tn T were independent risk factors of cardiotoxicity(P<0.05).Further analysis showed that age,anthracycline cumulative dose and LVEF value were significantly positively correlated(P<0.05).(4)The ROC curve results showed that the AUC value of hs-c Tn T in the diagnosis of cardiotoxicity was 0.731,the sensitivity was 76.5%,and the specificity was 66.5%.The number of abnormal ECG has no effect on predicting the occurrence of cardiotoxicity.Conclusion(1)The incidence of ECG abnormalities during anthracycline chemotherapy was 49.8%,ST-T changes is the main manifestation.(2)There were 51 cases of cardiotoxicity during chemotherapy,with an incidence of 20.31%.(3)Age,sex,the number of ECG abnormalities,hs-c Tn T abnormalities,and the cumulative dose of anthracyclines are independent risk factors for cardiotoxicity.Age,the cumulative dose of anthracyclines are significantly positively correlated with LVEF.(4)hs-c Tn T has certain diagnostic value for cardiotoxicity.