Speckle tracking imaging technique evaluates the impact of combined immune checkpoint inhibitors,trastuzumab,and chemotherapy on cardiac function in patients with advanced HER2-positive gastric adenocarcinoma
10.12025/j.issn.1008-6358.2024.20240473
- VernacularTitle:斑点追踪成像技术评估联合免疫检查点抑制剂、曲妥珠单抗及化疗对HER2阳性晚期胃腺癌患者心功能的影响
- Author:
Fulati ZIBIRE
1
;
Wen LIU
;
Haiyan CHEN
;
Yan WANG
;
Xianhong SHU
;
Leilei CHENG
Author Information
1. 复旦大学附属中山医院心脏超声诊断科,上海 200032
- Keywords:
gastric cancer;
immune checkpoint inhibitors;
trastuzumab;
speckle tracking echocardiography;
echocardiography;
cardio-oncology
- From:
Chinese Journal of Clinical Medicine
2024;31(4):537-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of combining immune checkpoint inhibitors,trastuzumab,and chemotherapy on the left and right ventricular function in patients with advanced gastric adenocarcinoma expressing human epidermal growth factor receptor 2(HER2).Methods 25 patients with advanced HER2-positive gastric adenocarcinoma who received HER2-ASTRUM therapy(sruili monoclonal antibody combined with trastuzumab and DOS regimen)underwent echocardiographic examinations at baseline(T1),after completion of 4 cycles(T2),and 6 cycles(T3)of chemotherapy.Left ventricular strain,left ventricular myocardial work,right ventricular strain,and ejection fraction were further analyzed.Results Compared with T1,both T2 and T3 showed a decrease in left ventricular ejection fraction(LVEF),(T1,T2,and T3 were[67.3±2.7]％,[63.0±2.9]％and[61.3±3.2]％,P＜0.05).T3 showed a decrease in right ventricular ejection fraction(RVEF),([59.3±7.8]％vs[43.7±6.6]％,P＜0.05),while T2 showed no significant change in RVEF.Both right ventricular global longitudinal strain(RVGLS),(T1,T2,and T3 were[-25.7±5.7]％,[-22.4±5.3]％and[-19.1±3.6]％,respectively;P＜0.05)and right ventricular free-wall longitudinal strain(RVFWLS),(T1,T2,and T3 were[-20.9±4.7]％,[-18.9±4.1]％and[-16.1±3.9]％,P＜0.05)decreased in all three time points.The global work index(GWI)was lower in T2 and T3 than in T1(P＜0.05),while the global constructive work(GCW),global wasted work(GWW),and global work efficiency(GWE)did not show significant changes.Conclusions Combination of trastuzumab,immune checkpoint inhibitors,and chemotherapy has an impact on left ventricular strain,LVEF,and right ventricular strain,as well as GWI,in HER2-positive patients with gastric adenocarcinoma.Left ventricular global longitudinal strain(LVGLS),RVFWLS,and RVGLS can more sensitively monitor cardiac function and detect cardiac dysfunction related to cancer treatment in a timely manner.
