Early Monitoring Of Cardiotoxicity In Breast Cancer Patients Induced By Anthracycline Chemotherapy

Obj ective:Breast cancer is one of the most common malignant tumors in women.Chemotherapy is one of the effective treatments for breast cancer patients.Anthracycline anticancer drugs have been widely used in chemotherapy for breast cancer patients.Anthracycline anti-tumor drugs as cytotoxic drugs,the heart damage caused by the cumulative dose per unit surface area has attracted the attention of the medical community.With the development of new anthracycline anti-tumor drugs,the rate of the incidence of cardiac structural and functional damage and death was significantly lower than before,but there was still damage to the cardiac microcirculation caused by low-dose drug toxicity in the early stage of chemotherapy.When the structure and function of the heart are damaged,it not only limits the treatment of breast cancer patients,but also affects its prognosis and quality of life.Therefore,early monitoring of cardiac microcirculation function and early treatment is extremely important.This topic will monitor the early cardiac damage of anthracycline anticancer drugs in breast cancer patients by monitoring the changes of cardiac function before and after chemotherapy in breast cancer patients by various tests and indicators.Methods:The first hospital of Shanxi Medical University was selected from November 2017 to November 2018.In the oncology department and general surgery,30 cases of female patients with breast cancer were diagnosed by postoperative pathology and an anthracycline antitumor drug chemotherapy program was proposed.12-channel electrocardiogram,cardiac Doppler ultrasound,troponin(cTnT),and B-type natriuretic peptide precursor(NT-proBNP)before and after the first cycle of anthracycline antitumor drugs after surgery)and PET myocardial blood flow measurement test.Among them,12-channel electrocardiogram was measured by ECG-1350P specification electrocardiograph,ECG results were interpreted by ECG room professionals;cardiac Doppler ultrasound was measured by Philips IE33 color Doppler ultrasound for ej ection fraction(LVEF%),by ultrasound Professional records and reports;cTnT,NT-proBNP collected 5ml venous blood with vacuum blood collection tube,and sent to our laboratory for laboratory testing,using DXI800B microparticle chemiluminescence,CARIS200 chemiluminescence microparticle immunoassay;PET myocardial blood flow quantitative measurement by me In the PET/CT room professional technician operation,professional imaging doctors performed image analysis to calculate the mean blood flow(MBF),mean blood flow(MBF)and coronary flow reserve(CFR).Finally,the above results were analyzed by SPSS22.0 statistical software.The measurement data were used to indicate that the comparison between groups was performed by paired sample test;the count data was expressed by frequency,and the comparison between groups was taken by t-test;Influencing factors of MBF after chemotherapy by multiple linear regression analysis;P<0.05 was considered statistically significantResults:Thirty patients with breast cancer were treated with 12-channel electrocardiogram,LUEF%,cTnT,and NT-proBNP,respectively,before treatment and after 4 cycles of treatment.P>0.05,the difference was not statistically significant;PETmyocardial blood flow measurement,suggesting mean resting myocardial blood flow before and after chemotherapy,and loading myocardial blood flow P<0.05,the difference was statistically significant;before and after treatment,the coronary flow reserve(CFR),P>0.05,the difference was not statistically significant;multiple linear regression analysis showed that resting MBF after chemotherapy and other medical history were the influencing factors of MBF after chemotherapy.Conclusion:Compared with electrocardiogram,LVEF,cTnT,NT-proBNP and other methods,PET myocardial blood flow may be more valuable for early monitoring of cardiac damage after anthracycline chemotherapy in breast cancer patients.