Phase analysis of gated myocardial perfusion imaging for early diagnosis of cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma
10.3760/cma.j.issn.2095-2848.2019.10.004
- VernacularTitle: 门控心肌灌注显像相位分析对弥漫性大B细胞淋巴瘤患者蒽环类药物所致心肌损害的早期诊断价值
- Author:
Chun QIU
1
;
Yan LIN
2
;
Weiying GU
2
;
Jianfeng WANG
1
;
Xiaoliang SHAO
1
;
Feifei ZHANG
1
;
Jiatian CHEN
1
;
Xiaoxia LI
1
;
Bai HE
2
;
Xiaobao XIE
2
;
Zhifang WU
3
;
Yuetao WANG
1
Author Information
1. Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China
2. Department of Hematology, the Third Affiliated Hospital of Soochow University, the First People′s Hospital of Changzhou, Changzhou 213003, China
3. Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan 030001, China
- Publication Type:Journal Article
- Keywords:
Lymphoma, large B cell, diffuse;
Drug therapy, combination;
Anthracyclines;
Ventricular function, left
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2019;39(10):591-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma (DLBCL).
Methods:Thirty-two patients (22 males, 10 females, age: 22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak filling rate (PFR), summed motion score (SMS) and summed thickening score (STS) as well as left ventricular systolic synchrony indicators including phase bandwidth (BW), phase standard deviation (SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis.
Results:Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8.68)°; SD: (11.65±4.64)° vs (8.79±3.14)°; entropy: (39.84±5.51)% vs (36.19±5.94)%; t values: -9.132 to -3.173, all P<0.05). There were no significant differences in other indicators (t values: -1.161 to 1.750, z values: -1.633 to -0.096, all P>0.05). Of 32 patients, 13 patients (40.62%) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchrony was significantly higher than that of left ventricular dysfunction (15.62%, 5/32; χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssynchrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)% vs (66.79±7.65)%; t=4.087, P<0.01).
Conclusion:Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indicator of cardiotoxicity caused by anthracycline chemotherapy.
