Acute Radiation Effects on Cardiac Function Detected by Strain Rate Imaging in Breast Cancer Patients

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• 作者：Katrien Erven M.D.^* ; ^{Katrien.erven@uzleuven.be} ; Ruxandra Jurcut M.D. ; Ph.D.^§ ; ; Caroline Weltens M.D. ; Ph.D.^* ; Sorin Giusca M.D.^§ ; ; Joris Ector M.D. ; Ph.D.^† ; ; Hans Wildiers M.D. ; Ph.D.^‡ ; ; Walter Van den Bogaert M.D. ; Ph.D.^* ; Jens-Uwe Voigt M.D. ; Ph.D.^† ;
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2011
• 出版时间：1 April 2011
• 年：2011
• 卷：79
• 期：5
• 页码：1444-1451
• 全文大小：706 K

文摘

Purpose

To investigate the occurrence of early radiation-induced changes in regional cardiac function using strain rate imaging (SRI) by tissue Doppler echocardiography.

Methods and Materials

We included 20 left-sided and 10 right-sided breast cancer patients receiving radiotherapy (RT) to the breast or chest wall. Standard echocardiography and SRI were performed before RT (baseline), immediately after RT (post-RT), and at 2 months follow-up (FUP) after RT. Regional strain (S) and strain rate (SR) values were obtained from all 18 left ventricular (LV) segments. Data were compared to the regional radiation dose.

Results

A reduction in S was observed post-RT and at FUP in left-sided patients (S_post-RT: −17.6 ± 1.5 % , and S_FUP: −17.4 ± 2.3 % , vs. S_baseline: −19.5 ± 2.1 % , p < 0.001) but not in right-sided patients. Within the left-sided patient group, S and SR were significantly reduced after RT in apical LV segments (S_post-RT: −15.3 ± 2.5 % , and S_FUP: −14.3 ± 3.7 % , vs. S_baseline: −19.3 ± 3.0 % , p < 0.01; and SR_post-RT: −1.06 ± 0.15 s ⁻¹, and SR_FUP: −1.16 ± 0.28 s ⁻¹, vs. SR_baseline: −1.29 ± 0.27s ⁻¹, p = 0.01), but not in mid- or basal segments. Furthermore, we observed that segments exposed to more than 3 Gy showed a significant decrease in S after RT (S_post-RT: −16.1 ± 1.6 % , and S_FUP: −15.8 ± 3.4 % , vs. S_baseline: −18.9 ± 2.6 % , p < 0.001). This could not be observed in segments receiving less than 3 Gy.

Conclusions

SRI shows a dose-related regional decrease in myocardial function after RT. It might be a useful tool in the evaluation of modern RT techniques, with respect to cardiac toxicity.