Due to advances in modern tumor treatments, patients can survive long-term. However, cardiotoxicity caused by tumor therapy poses a significant challenge to both physicians and patients. Early detection and accurate a...Due to advances in modern tumor treatments, patients can survive long-term. However, cardiotoxicity caused by tumor therapy poses a significant challenge to both physicians and patients. Early detection and accurate assessment of cardiovascular toxicity from tumor therapy are crucial for guiding clinical treatment and improving patient prognosis. A noninvasive myocardial workup can monitor and assess the development of tumor chemotherapy-related cardiotoxicity. In monitoring oncology chemotherapy-related cardiac injury, a significant decrease in left ventricular ejection fraction (LVEF) of left ventricular systolic function (LVSCF) often indicates severe cardiac injury, making it challenging to monitor early cardiac injury. 3D-STI (three-dimensional speckle tracking imaging) can evaluate early cardiac injury, but its load dependence reduces the accuracy of myocardial function evaluation. In contrast, the noninvasive evaluation of myocardial work using left ventricular pressure-strain loops (PSL), which considers both myocardial deformation and left ventricular pressure, avoids the effect of load dependence on myocardial contractile function and improves the accuracy of myocardial function evaluation. This article reviews the noninvasive evaluation of myocardial work to assess cardiotoxicity associated with tumor chemotherapy.展开更多
目的:探讨甘油三酯⁃葡萄糖(triglyceride⁃glucose,TyG)指数与亚临床左心室收缩功能障碍的独立关联,分析其对左心室整体纵向应变(global longitudinal strain,GLS)及左心室做功指数的影响。方法:纳入2024年8月—2025年2月收治的103例患者...目的:探讨甘油三酯⁃葡萄糖(triglyceride⁃glucose,TyG)指数与亚临床左心室收缩功能障碍的独立关联,分析其对左心室整体纵向应变(global longitudinal strain,GLS)及左心室做功指数的影响。方法:纳入2024年8月—2025年2月收治的103例患者,采集患者临床参数、生化指标及超声心动图数据,计算TyG指数。通过GE EchoPAC工作站获取GLS及左室做功参数,包括整体做功指数(global work index,GWI)、整体有用功指数(global constructive work,GCW)、整体无用功指数(global wasted work,GWW)和整体做功效率指数(global work efficiency,GWE),采用多因素Logistic回归分析TyG指数与左室功能异常的独立关联。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估TyG指数对左心室功能障碍的预测效能,计算曲线下面积(area under the curve,AUC)、最佳截断值、灵敏度及特异度。结果:高TyG指数组与低TyG指数组相比,高血压(67.31%vs.43.14%)、糖尿病(42.31%vs.7.84%)及高脂血症(34.62%vs.3.92%)患病率显著升高(P均<0.05)。GLS绝对值(-17.60±2.65 vs.-19.82±2.12)、GWI[(1672.33±308.58)mmHg%vs.(1932.31±280.26)mmHg%]及GCW[(1999.46±324.11)mmHg%vs.(2299.20±323.32)mmHg%]均显著降低(P均<0.001)。调整年龄、性别、BMI、血压、血脂等混杂因素后,TyG指数升高仍为GLS降低(OR=2.982,95%CI:1.182~7.522,P=0.021)、GWI降低(OR=3.168,95%CI:1.302~7.706,P=0.011)及GCW降低(OR=2.836,95%CI:1.250~7.309,P=0.021)的独立危险因素。ROC曲线显示出TyG指数对GLS、GWI及GCW降低的预测效能,AUC分别为0.725、0.697、0.683。结论:TyG指数升高与GLS及心肌做功能力下降独立相关,是亚临床左心室功能障碍的潜在生物标志物,提示其在代谢性心血管疾病早期风险评估中的临床应用价值。展开更多
目的:采用左心室压力-应变环(LV-PSL)技术评估妊娠期糖尿病(GDM)患者的左心室心肌功能变化,并探讨导致心肌功能减退的相关风险因素。方法:本研究为前瞻性随机研究,纳入2022年7月至2024年7月期间来我院就诊并确诊为GDM的孕妇98例(GDM组)...目的:采用左心室压力-应变环(LV-PSL)技术评估妊娠期糖尿病(GDM)患者的左心室心肌功能变化,并探讨导致心肌功能减退的相关风险因素。方法:本研究为前瞻性随机研究,纳入2022年7月至2024年7月期间来我院就诊并确诊为GDM的孕妇98例(GDM组),另选取同期健康孕妇80例作为对照组(NC组)。收集两组孕妇的常规超声心动图和二维斑点追踪超声心动图指标,并利用LV-PSL技术对左心室心肌做功指标进行评估。结果:与对照组相比,GDM组的整体纵向应变(GLS)、整体做功指数(GWI)、整体做功效率(GWE)和整体有效做功(GCW)值均显著降低,整体无效做功(GWW)显著增高(均P<0.01),而常规超声心动图指标在两组间无显著差异(均P>0.05)。GWI、GWE、GCW、GWW和GLS在预测GDM患者心功能变化方面表现出较高的预测价值,ROC曲线下面积(AUC)分别为0.859、0.912、0.871、0.823和0.903。GWI、GWE、GCW与GLS呈负相关(r=-0.518,-0.477,-0.463,均P<0.001),而GWW与GLS呈正相关(r=0.392,P<0.001)。GWI、GWE、GCW与HbA1c水平呈负相关(r=-0.354,-0.302,-0.271,均P<0.05),而GWW与HbA1c水平呈正相关(r=0.181,P<0.05)。多因素Logistic回归分析表明,1 h OGTT、2 h OGTT和HbA1c是GDM患者左心室收缩功能的显著影响因素。结论:LV-PSL技术是早期检测GDM患者左心室收缩功能损害的有效工具。展开更多
文摘Due to advances in modern tumor treatments, patients can survive long-term. However, cardiotoxicity caused by tumor therapy poses a significant challenge to both physicians and patients. Early detection and accurate assessment of cardiovascular toxicity from tumor therapy are crucial for guiding clinical treatment and improving patient prognosis. A noninvasive myocardial workup can monitor and assess the development of tumor chemotherapy-related cardiotoxicity. In monitoring oncology chemotherapy-related cardiac injury, a significant decrease in left ventricular ejection fraction (LVEF) of left ventricular systolic function (LVSCF) often indicates severe cardiac injury, making it challenging to monitor early cardiac injury. 3D-STI (three-dimensional speckle tracking imaging) can evaluate early cardiac injury, but its load dependence reduces the accuracy of myocardial function evaluation. In contrast, the noninvasive evaluation of myocardial work using left ventricular pressure-strain loops (PSL), which considers both myocardial deformation and left ventricular pressure, avoids the effect of load dependence on myocardial contractile function and improves the accuracy of myocardial function evaluation. This article reviews the noninvasive evaluation of myocardial work to assess cardiotoxicity associated with tumor chemotherapy.
文摘目的:探讨甘油三酯⁃葡萄糖(triglyceride⁃glucose,TyG)指数与亚临床左心室收缩功能障碍的独立关联,分析其对左心室整体纵向应变(global longitudinal strain,GLS)及左心室做功指数的影响。方法:纳入2024年8月—2025年2月收治的103例患者,采集患者临床参数、生化指标及超声心动图数据,计算TyG指数。通过GE EchoPAC工作站获取GLS及左室做功参数,包括整体做功指数(global work index,GWI)、整体有用功指数(global constructive work,GCW)、整体无用功指数(global wasted work,GWW)和整体做功效率指数(global work efficiency,GWE),采用多因素Logistic回归分析TyG指数与左室功能异常的独立关联。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估TyG指数对左心室功能障碍的预测效能,计算曲线下面积(area under the curve,AUC)、最佳截断值、灵敏度及特异度。结果:高TyG指数组与低TyG指数组相比,高血压(67.31%vs.43.14%)、糖尿病(42.31%vs.7.84%)及高脂血症(34.62%vs.3.92%)患病率显著升高(P均<0.05)。GLS绝对值(-17.60±2.65 vs.-19.82±2.12)、GWI[(1672.33±308.58)mmHg%vs.(1932.31±280.26)mmHg%]及GCW[(1999.46±324.11)mmHg%vs.(2299.20±323.32)mmHg%]均显著降低(P均<0.001)。调整年龄、性别、BMI、血压、血脂等混杂因素后,TyG指数升高仍为GLS降低(OR=2.982,95%CI:1.182~7.522,P=0.021)、GWI降低(OR=3.168,95%CI:1.302~7.706,P=0.011)及GCW降低(OR=2.836,95%CI:1.250~7.309,P=0.021)的独立危险因素。ROC曲线显示出TyG指数对GLS、GWI及GCW降低的预测效能,AUC分别为0.725、0.697、0.683。结论:TyG指数升高与GLS及心肌做功能力下降独立相关,是亚临床左心室功能障碍的潜在生物标志物,提示其在代谢性心血管疾病早期风险评估中的临床应用价值。
文摘目的:采用左心室压力-应变环(LV-PSL)技术评估妊娠期糖尿病(GDM)患者的左心室心肌功能变化,并探讨导致心肌功能减退的相关风险因素。方法:本研究为前瞻性随机研究,纳入2022年7月至2024年7月期间来我院就诊并确诊为GDM的孕妇98例(GDM组),另选取同期健康孕妇80例作为对照组(NC组)。收集两组孕妇的常规超声心动图和二维斑点追踪超声心动图指标,并利用LV-PSL技术对左心室心肌做功指标进行评估。结果:与对照组相比,GDM组的整体纵向应变(GLS)、整体做功指数(GWI)、整体做功效率(GWE)和整体有效做功(GCW)值均显著降低,整体无效做功(GWW)显著增高(均P<0.01),而常规超声心动图指标在两组间无显著差异(均P>0.05)。GWI、GWE、GCW、GWW和GLS在预测GDM患者心功能变化方面表现出较高的预测价值,ROC曲线下面积(AUC)分别为0.859、0.912、0.871、0.823和0.903。GWI、GWE、GCW与GLS呈负相关(r=-0.518,-0.477,-0.463,均P<0.001),而GWW与GLS呈正相关(r=0.392,P<0.001)。GWI、GWE、GCW与HbA1c水平呈负相关(r=-0.354,-0.302,-0.271,均P<0.05),而GWW与HbA1c水平呈正相关(r=0.181,P<0.05)。多因素Logistic回归分析表明,1 h OGTT、2 h OGTT和HbA1c是GDM患者左心室收缩功能的显著影响因素。结论:LV-PSL技术是早期检测GDM患者左心室收缩功能损害的有效工具。
