Autotrain RV技术在治疗癌症化疗患者右心室心肌改变中的重要性-动脉网

The importance of the Autostrain RV technique in the treatment of right ventricular myocardial alterations in patients with breast cancer receiving chemotherapy

Nature 等信源发布 2025-01-22 16:20



可切换为仅中文







Abstract

摘要

To research the value of Autostrain right ventricular (RV) technology in detecting and preventing right ventricular myocardial injury in patients undergoing breast cancer chemotherapy by providing an imaging basis for early identification. To examine the changes in various cardiac function parameters before and after chemotherapy, two-dimensional echocardiography was employed 48 h before chemotherapy, 48 h after the fourth cycle of chemotherapy, and 48 h after the eighth cycle of chemotherapy, respectively.

研究自动训练右心室（RV）技术在检测和预防乳腺癌化疗患者右心室心肌损伤中的价值，为早期识别提供影像学依据。为了检查化疗前后各种心功能参数的变化，分别在化疗前48小时，化疗第四周期后48小时和化疗第八周期后48小时使用二维超声心动图。

The patients included those with breast cancer who underwent surgery and were primarily administered anthracycline-based chemotherapeutic drugs. (1) Compared with the pre-chemotherapy period, the absolute values of the right ventricular global longitudinal strain (RV4CSL) and right ventricular free-wall longitudinal strain (RVFWSL) decreased after the fourth chemotherapy cycle, and no significant differences were observed in tricuspidannular plane systolic excursion (TAPSE), right ventricular Tei index, and right ventricular fractional area change (FAC); (2) Compared with the pre-chemotherapy period, the absolute values of RV4CSL and RVFWSL decreased after the eighth chemotherapy cycle.

这些患者包括那些接受手术的乳腺癌患者，他们主要服用蒽环类化疗药物。（1）与化疗前相比，第四个化疗周期后右心室整体纵向应变（RV4CSL）和右心室游离壁纵向应变（RVFWSL）的绝对值下降，三尖瓣平面收缩偏移（TAPSE），右心室Tei指数和右心室分数面积变化（FAC）无显着差异；（2）与化疗前相比，第八个化疗周期后RV4CSL和RVFWSL的绝对值下降。

TAPSE and FAC decreased, the right ventricular Tei index increased; (3) Compared with the end of the fourth chemotherapy cycle, the absolute values of RV4CSL and RVFWSL decreased at the end of the eighth chemotherapy cycle. TAPSE, right ventricular Tei index and FAC were not significantly different.

TAPSE和FAC降低，右心室Tei指数升高；（3）与第四个化疗周期结束时相比，第八个化疗周期结束时RV4CSL和RVFWSL的绝对值下降。TAPSE，右心室Tei指数和FAC无显着差异。

(4) Pearson correlation analysis revealed a correlation between the absolute value of RV4CSL, the absolute value of RVFWSL, right ventricular Tei index, TAPSE and FAC. The absolute values of RV4CSL and RVFWSL are sensitive indices that reflect changes in the right ventricular myocardium in.

（4） Pearson相关分析显示RV4CSL绝对值，RVFWSL绝对值，右心室Tei指数，TAPSE和FAC之间存在相关性。RV4CSL和RVFWSL的绝对值是反映右心室心肌变化的敏感指标。

Background

背景

Breast cancer, one of the most prevalent malignant tumors worldwide, poses a severe threat to human health as its frequency increases annually. Anthracyclines are currently a part of the standard postoperative chemotherapy regimen for patients with breast cancer. Postoperative chemotherapy is a successful treatment for breast cancer; however, it can have cardiotoxic side effects that can result in irreparable heart damage.

乳腺癌是世界上最普遍的恶性肿瘤之一，随着其频率每年增加，对人类健康构成严重威胁。蒽环类药物目前是乳腺癌患者标准术后化疗方案的一部分。术后化疗是乳腺癌的成功治疗方法；然而，它可能具有心脏毒性副作用，可能导致不可修复的心脏损伤。

. Previously, only relatively insensitive indicators such as clinical symptoms and left ventricular ejection fraction were used to monitor cardiac function, which may have resulted in missed opportunities for early detection and effective treatment

以前，只有相对不敏感的指标，如临床症状和左心室射血分数被用来监测心脏功能，这可能导致错过早期发现和有效治疗的机会

. Echocardiography has been suggested as the primary technique for detecting cardiac insufficiency before and after chemotherapy

超声心动图被认为是检测化疗前后心功能不全的主要技术

. Early detection of subclinical cardiotoxicity is crucial for patients with breast cancer to initiate cardioprotective therapy promptly to prevent overt cardiac dysfunction and heart failure. With limited research on overall and local functional alterations in the right ventricle, anthracycline-induced changes in the general function of the left ventricle after chemotherapy following breast cancer surgery have received more attention.

早期发现亚临床心脏毒性对于乳腺癌患者迅速开始心脏保护治疗以预防明显的心脏功能障碍和心力衰竭至关重要。由于对右心室整体和局部功能改变的研究有限，蒽环类药物引起的乳腺癌手术后化疗后左心室一般功能的变化受到了更多关注。

. The shape of the right ventricle and its global and local functions play a crucial role in the prevalence of heart disease and mortality

右心室的形状及其整体和局部功能在心脏病的患病率和死亡率中起着至关重要的作用

The Philips Autostrain RV technology(Philips, Amsterdam, the Netherlands) is an automatic strain analysis system that accurately determines the right ventricular boundary and rapidly calculates the overall longitudinal strain value of the right ventricle without requiring laborious manual depiction.

飞利浦Autostrain RV技术（飞利浦，阿姆斯特丹，荷兰）是一种自动应变分析系统，可准确确定右心室边界，并快速计算右心室的整体纵向应变值，而无需费力的手动描绘。

It is simple to use.

它使用起来很简单。

and is based on two dimensions, making it simple to promote. In addition to providing an imaging basis for the early clinical detection and prevention of right ventricular myocardial injury, we aimed to clarify the application value of Autostrain RV technology in right ventricular myocardial alterations in patients receiving chemotherapy for breast cancer..

并且基于两个维度，因此易于推广。除了为早期临床检测和预防右心室心肌损伤提供影像学基础外，我们还旨在阐明Autostrain RV技术在乳腺癌化疗患者右心室心肌改变中的应用价值。。

Materials and methods

材料和方法

Clinical data

临床数据

We recruited 58 volunteers; 11 patients did not complete the ultrasound examination process, three had unclear ultrasound images, three did not undergo ultrasound examination at the specified time, and one patient requested to be withdrawn from the study. All patients signed an informed consent form, and the study was approved by the hospital ethics committee.

我们招募了58名志愿者；11名患者未完成超声检查过程，3名超声图像不清楚，3名患者未在指定时间进行超声检查，1名患者要求退出研究。所有患者均签署了知情同意书，该研究得到了医院伦理委员会的批准。

Finally, we collected the data of patients with postoperative pathologically confirmed breast cancer diagnosis in the Breast Surgery Department of the First Hospital Affiliated to the Hebei North College from October 2022 to June 2023. The patients received anthracycline-based chemotherapy in our hospital.

最后，我们收集了2022年10月至2023年6月河北北方学院附属第一医院乳腺外科术后病理确诊的乳腺癌患者的数据。患者在我院接受了蒽环类化疗。

We included 40 female patients aged 36–71 years, with a mean age of 55.4 ± 7.7 years. BMI 18–24 kg/m.

我们纳入了40名年龄在36-71岁之间的女性患者，平均年龄为55.4±7.7岁。体重指数18-24公斤/米。

, mean (21.6 ± 1.8) kg/m

，平均（21.6±1.8）公斤/米

. An AC-T chemotherapy regimen was used. Liposomal doxorubicin (30 mg/m

.使用AC-T化疗方案。

) and cyclophosphamide (600 mg/m

)和环磷酰胺（600毫克/米

) were used in cycles one through four, and docetaxel (260 mg/m

)用于第1至第4周期，多西紫杉醇（260 mg/m

) in cycles five through eight. None of the patients had hypertension, hypercholesterolemia, smoking, and drug therapy. The inclusion criteria were: (I) first-time of receiving chemotherapy, (II) a chemotherapy regimen of eight cycles of chemotherapy at 3-week intervals, and (III) chemotherapy using the same anthracycline drugs.

)在第五到第八个周期中。没有患者患有高血压，高胆固醇血症，吸烟和药物治疗。纳入标准为：（I）首次接受化疗，（II）每隔3周进行8个化疗周期的化疗方案，以及（III）使用相同的蒽环类药物进行化疗。

The exclusion criteria were: (I) irregular chemotherapy schedule, (II) unclear ultrasonographic images, (III) incomplete collection of trial data, and (IV) a history of radiotherapy..

排除标准为：（I）化疗时间表不规则，（II）超声图像不清楚，（III）试验数据收集不完整，以及（IV）放疗史。。

Image acquisition and analysis

图像采集与分析

Instruments and methods

仪器和方法

A PHILIPS EPIQ7C Doppler diagnostic ultrasound machine(Philips, Amsterdam, the Netherlands), S5-1 phased array probe, frequency 1.0–5.0 MHz, equipped with offline analysis software (Qlab version 13.0.0, Philips, the Netherlands), was used to perform echocardiography. The patients underwent echocardiographic examination 48 h before chemotherapy and 48 h after the fourth and eighth cycles of chemotherapy (Fig. .

使用配备离线分析软件（Qlab版本13.0.0，荷兰飞利浦）的飞利浦EPIQ7C多普勒诊断超声机（飞利浦，阿姆斯特丹，荷兰），S5-1相控阵探头，频率1.0-5.0 MHz）进行超声心动图检查。患者在化疗前48小时和化疗第四和第八周期后48小时接受超声心动图检查（图）。

). The tricuspidannular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC) and the right ventricular Tei index were acquired by conventional echocardiography. The right ventricular free-wall longitudinal strain (the absolute value of RVFWSL) and the right ventricular global longitudinal strain (the absolute value of RV4CSL) were acquired using the Autostrain RV technique.

)。通过常规超声心动图获得三尖瓣环平面收缩偏移（TAPSE），右心室分数面积变化（FAC）和右心室Tei指数。使用Autostrain RV技术获得右心室游离壁纵向应变（RVFWSL的绝对值）和右心室整体纵向应变（RV4CSL的绝对值）。

All images were acquired by the same examiner, and all the data were averaged over three measurements. Methods were performed in accordance with the relevant guidelines and regulations.

所有图像均由同一位检查员采集，所有数据均在三次测量中取平均值。方法按照相关指南和规定进行。

Two-dimensional echocardiographic parameters

二维超声心动图参数

Valve annular displacement (TAPSE): TAPSE is easily obtainable and represents a measure of RV longitudinal function. TAPSE established prognostic value

阀环位移（TAPSE）：TAPSE很容易获得，代表RV纵向功能的量度。TAPSE确定的预后价值

. Decreased TAPSE means decreased cardiac function. Measurement of TAPSE: Tricuspid annular longitudinal excursion by M-mode (cm), measured between end-diastole and peak systole. Proper alignment of M-mode cursor with the direction of RV longitudinal excursion should be achieved from the apical approach.

.TAPSE降低意味着心脏功能降低。TAPSE的测量：通过M型（cm）测量三尖瓣环的纵向偏移，在舒张末期和收缩期峰值之间测量。应从心尖入路实现M型光标与RV纵向偏移方向的正确对齐。

(Fig. .

（图。

RVFAC was calculated by measuring the right ventricle end-diastolic area and the end-systolic area from the focused RV apical four-chamber view (Fig.

。

). RVFAC reflects overall right ventricular systolic function; FAC > 35% with normal right ventricular systolic function

)。RVFAC反映整体右心室收缩功能；右心室收缩功能正常的FAC>35%

The Tei index, or the index of myocardial work production, is valuable for evaluating overall ventricular function

Tei指数或心肌功产生指数对评估整体心室功能很有价值

. Increased Tei Index indicates decreased cardiac function. Measurement of Tei index: The TDI-PW function was selected, and the sampling point was placed in the tricuspid valve at the junction of the anterior leaflet and the annulus to obtain the tissue Doppler spectrum of the tricuspid valve. The following calculation was performed: RV-Tei=(RVtime1-RVtime2)/RVtime2 (Fig. .

Tei指数增加表明心脏功能下降。。进行了以下计算：RV Tei=（RVtime1-RVtime2）/RVtime2（图）。

The Autostrain RV technology for measuring ventricular strain

Autostrain RV技术测量心室应变

The patient was instructed to lie on the left side while breathing calmly and synchronously connected to the electrocardiogram instrument. After obtaining a stable heart rate, the image gain was adjusted to obtain a clear right ventricular dominant apical four-chamber cardiac section (the requirements were a clear display of the right ventricular free wall, the apical portion of the right ventricle, and the tricuspid valve annulus).

指示患者躺在左侧，同时平静地呼吸，并与心电图仪同步。在获得稳定的心率后，调整图像增益以获得清晰的右心室优势心尖四腔心脏切面（要求清晰显示右心室游离壁，右心室心尖部分和三尖瓣环）。

To obtain a clear image, the patients were instructed to hold their breath, and a stable dynamic image was acquired. Three cardiac cycles were captured, and the image was imported into the Tom Tec workstation for quantitative analysis. After storing the dynamic images in Review and selecting the Autostrain RV function, the instrument automatically identified the right ventricular diastole and systole (Fig. .

为了获得清晰的图像，指示患者屏住呼吸，并获得稳定的动态图像。捕获了三个心动周期，并将图像导入Tom-Tec工作站进行定量分析。在查看动态图像并选择Autostrain RV功能后，仪器自动识别右心室舒张和收缩（图）。

) and analyzed the RVFWSL and RV4CSL(The values are negative.) (Fig.

)并分析了RVFWSL和RV4CSL（值为负值）（图）。

). We used the absolute values of RVFWSL and RV4CSL.

)。我们使用了RVFWSL和RV4CSL的绝对值。

Statistical analysis

统计分析

SPSS 26.0 statistical analysis software(version 26.0, IBM, Armonk, NY, USA) was used for all analyses. Normally distributed measurements were expressed as means ± standard deviations (

所有分析均使用SPSS 26.0统计分析软件（版本26.0，IBM，Armonk，NY，USA）。正态分布的测量值表示为平均值±标准偏差(

\({{\bar{\text{x}}}}\)

\（{{\bar{\text{x}}}}\）

± s). The parameters of each group were analyzed by one-way analysis of variance if all of them met the variance chi-square normal distribution. Otherwise, multiple independent samples nonparametric tests were used. Pearson’s correlation coefficient was used for correlation analysis. Differences were considered statistically significant at .

±s）。如果各组的参数均符合方差卡方正态分布，则通过单因素方差分析进行分析。否则，使用多个独立样本非参数检验。皮尔逊相关系数用于相关分析。差异被认为具有统计学意义。

< 0.05.

< 0.05。

Results

结果

Comparative analysis of patients’ parameters before and after chemotherapy

化疗前后患者参数对比分析

Compared with the pre-chemotherapy period, the absolute values of RV4CSL and RVFWSL reduced after the fourth cycle of chemotherapy (

与化疗前相比，第四个化疗周期后RV4CSL和RVFWSL的绝对值降低(

< 0.05), and the absolute values of RV4CSL and RVFWSL further reduced after the eighth cycle (

<0.05），第八个周期后，RV4CSL和RVFWSL的绝对值进一步降低(

< 0.01) (Figs.

<0.01）（图。

and

和

). Compared with the pre-chemotherapy period, no significant differences were observed in TAPSE, the right ventricular Tei index and FAC at the end of the fourth cycle of chemotherapy (

)。与化疗前相比，第四周期化疗结束时TAPSE、右心室Tei指数和FAC无显著性差异(

> 0.05). Compared with the pre-chemotherapy period, at the end of cycle 8 of chemotherapy, we observed a decrease in TAPSE (

>0.05）。与化疗前相比，在化疗第8周期结束时，我们观察到TAPSE下降(

< 0.01) and FAC (

< 0.01）和 FAC（

< 0.01), an increase in right ventricular Tei index (

<0.01），右心室Tei指数增加(

< 0.01). Compared with the end of the fourth chemotherapy cycle, patients had lower absolute values of RV4CSL and RVFWSL at the end of the eighth chemotherapy cycle (

<0.01）。与第四个化疗周期结束时相比，患者在第八个化疗周期结束时的RV4CSL和RVFWSL绝对值较低(

< 0.01). We observed no significant differences in TAPSE, right ventricular Tei index and FAC (

<0.01）。我们观察到TAPSE，右心室Tei指数和FAC无显着差异(

> 0.05) (Figs.

>0.05）（图。

and

和

; Table

；表格

Table 1 Comparison of Echocardiographic Parameters at different chemotherapy stages.

表1不同化疗阶段超声心动图参数的比较。

Full size table

全尺寸表

Correlation analysis

Pearson’s correlation analysis revealed a correlation between the absolute value of RV4CSL, the absolute value of RVFWSL, right ventricular Tei index, TAPSE and FAC (

Pearson相关分析显示RV4CSL的绝对值，RVFWSL的绝对值，右心室Tei指数，TAPSE和FAC之间存在相关性(

< 0.05). TAPSE (

< 0.05).小吃(

= 0.25,

= 0.25，

= 0.007), FAC (

=0.007），FAC(

= 0.23,

= 0.23，

= 0.012), and the absolute value of RV4CSL (

=0.012），和RV4CSL的绝对值(

= 0.94,

= 0.94，

= 0.000) before and after chemotherapy were positively correlated with the absolute value of RVFWSL. The right ventricular Tei index (

=（0.000）化疗前后与RVFWSL的绝对值呈正相关。右心室Tei指数(

= -0.37,

= 0.000) was negatively correlated with the absolute value of RVFWSL. Pearson correlation analysis showed TAPSE (

==0.000）与RVFWSL的绝对值呈负相关。Pearson相关分析显示TAPSE(

= 0.20,

= 0.20，

= 0.028), FAC (

= 0.028），FAC（

= 0.20,

= 0.20，

= 0.031), the absolute value of RVFWSL (

=0.031），RVFWSL的绝对值(

= 0.94,

= 0.94，

= 0.000)before and after chemotherapy were positively correlated with the absolute value of RV4CSL. The right ventricular Tei index (

化疗前后与RV4CSL绝对值呈正相关。右心室Tei指数(

= -0.38,

= 0.000) was negatively correlated with the absolute value of RV4CSL (Table

==0.000）与RV4CSL的绝对值呈负相关（表

Table 2 Pearson correlation analysis.

表2 Pearson相关分析。

Full size table

全尺寸表

Discussion

讨论

Breast cancer is typically treated using a combination of surgery and chemotherapy, which can significantly improve its prognosis. However, one of the toxic side effects of chemotherapy is myocardial toxicity, which can cause cardiomyopathy or cardiac failure

乳腺癌通常采用手术和化疗相结合的方法进行治疗，这可以显着改善其预后。然而，化疗的毒副作用之一是心肌毒性，可引起心肌病或心力衰竭

. Some drugs can cause various forms of myocardial toxicity

.一些药物会引起各种形式的心肌毒性

. Anthracyclines are the most commonly used broad-spectrum antitumor drugs for breast cancer

蒽环类药物是治疗乳腺癌最常用的广谱抗肿瘤药物

. It can effectively improve the survival rate of patients with breast cancer and reduce recurrence and metastasis

。它可以有效提高乳腺癌患者的生存率，减少复发和转移

. However, the myocardial toxicity of anthracyclines can cause irreversible damage to the myocardium

然而，蒽环类药物的心肌毒性会对心肌造成不可逆转的损伤

. Anthracyclines can affect myocardial rotational and torsional function at an early stage; their cardiac toxicity is dose-dependent, causing a decline in cardiac function even at low doses

蒽环类药物可在早期影响心肌旋转和扭转功能；它们的心脏毒性是剂量依赖性的，即使在低剂量下也会导致心脏功能下降

. The higher the cumulative dose, the greater the effect on the myocardium. Significant individual differences exist in the degree and onset of anthracycline cardiotoxicity, and no absolute safe dose has been established; it often exhibits a cumulative effect

累积剂量越高，对心肌的影响越大。蒽环类药物心脏毒性的程度和发作存在显着的个体差异，并且尚未确定绝对安全剂量；它通常表现出累积效应

. Therefore, myocardial toxicity secondary to anthracyclines may affect the long-term prognosis of patients with breast cancer. Statistically, cardiovascular complications have become the second leading cause of end-of-life complications in patients with malignant tumors (the first leading cause is the malignant tumor itself).

因此，蒽环类药物继发的心肌毒性可能会影响乳腺癌患者的长期预后。据统计，心血管并发症已成为恶性肿瘤患者死亡并发症的第二大原因（第一大原因是恶性肿瘤本身）。

The challenge in using anthracyclines for breast cancer treatment lies in balancing their antitumor efficacy with the risk of chronic cardiac damage. Monitoring cardiac function in patients with breast cancer taking anthracyclines is essential for the early detection of drug-induced cardiac damage. Early intervention can prevent subsequent severe clinical symptoms and reduce the risk of cardiotoxicity in patients undergoing chemotherapy.

使用蒽环类药物治疗乳腺癌的挑战在于平衡其抗肿瘤功效与慢性心脏损伤的风险。监测服用蒽环类药物的乳腺癌患者的心脏功能对于早期发现药物引起的心脏损伤至关重要。早期干预可以预防随后的严重临床症状，并降低接受化疗的患者发生心脏毒性的风险。

. Increasing attention has been paid in recent years to both domestic and international research on myocardial function following breast cancer chemotherapy. However, most of the studies that have been conducted in the past on these patients have concentrated on the left ventricle, with few studies considering myocardial injury in the right ventricle.

近年来，国内外对乳腺癌化疗后心肌功能的研究越来越受到重视。然而，过去对这些患者进行的大多数研究都集中在左心室，很少有研究考虑右心室的心肌损伤。

Deeper research has revealed that the clinical symptoms caused by right ventricular myocardial injury should be sufficiently considered to improve the clinical judgment of the patient’s condition, treatment selection, and prognostic assessment.

更深入的研究表明，应充分考虑由右心室心肌损伤引起的临床症状，以改善对患者病情的临床判断，治疗选择和预后评估。

. Correct and quantitative assessment of the right ventricular structure and function is important

正确和定量评估右心室的结构和功能很重要

. Early detection and intervention in the clinic can significantly reduce the rate of adverse cardiac events

.临床上的早期发现和干预可以显着降低不良心脏事件的发生率

The absolute values of RV4CSL and RVFWSL were reduced at the end of the fourth chemotherapy cycle (

在第四个化疗周期结束时，RV4CSL和RVFWSL的绝对值降低(

< 0.05) and further reduced at the end of the eighth chemotherapy cycle (

<0.05），并在第八个化疗周期结束时进一步降低(

< 0.01), which is consistent with the results of Keramida et al.

<0.01），这与Keramida等人的结果一致。

and Gu et al.

和顾等人。

, demonstrating that ultrasound strain parameters may be a more sensitive and accurate indicator of myocardial injury. First, the right ventricle is smaller than the left ventricle; thus, it may be affected to a greater extent and for a shorter period. Second, the right ventricle has a thinner myocardial layer, fewer myocardial fibers, and a weaker compensatory capacity, which makes it more sensitive to the toxic effects of anthracyclines; patients with concomitant right cardiac insufficiency have a worse prognosis for left-sided cardiac impairment.

，表明超声应变参数可能是心肌损伤的更敏感和更准确的指标。首先，右心室比左心室小；因此，它可能会受到更大程度和更短时间的影响。其次，右心室心肌层较薄，心肌纤维较少，代偿能力较弱，这使其对蒽环类药物的毒性作用更敏感；伴有右心功能不全的患者左侧心脏损害的预后较差。

. Impairment of the right ventricular structure and function greatly impacts the prognosis and mortality of patients with cardiovascular disease

.右心室结构和功能的损害极大地影响了心血管疾病患者的预后和死亡率

. Zhang et al.

张等人。

used Three-dimensional speckle tracking imaging technology (3D-STI) to study the ventricular function of patients with breast cancer receiving anthracycline chemotherapy and discovered that all of their right ventricular strain parameters were significantly reduced after chemotherapy compared with those before chemotherapy, and some of the strain parameters of the right ventricle changed earlier than those of the left ventricle.

使用三维斑点追踪成像技术（3D-STI）研究接受蒽环类化疗的乳腺癌患者的心室功能，发现化疗后患者的所有右心室应变参数均较化疗前显着降低，并且右心室的一些应变参数变化早于左心室。

Gu et al..

顾等人。。

applied Autostrain and observed a significant reduction in both the absolute values of RVFWSL and RV4CSL in the chemotherapy group. This suggests that right ventricular myocardial function can be impaired after anthracycline-based chemotherapy, and right ventricular strain parameters may be earlier than left ventricular strain in assessing chemotherapy-related cardiotoxicity.

应用自动训练，观察到化疗组RVFWSL和RV4CSL的绝对值均显着降低。这表明蒽环类化疗后右心室心肌功能可能受损，在评估化疗相关心脏毒性时，右心室应变参数可能早于左心室应变。

Cherata et al..

Cherata等人

reported that longitudinal strain analysis can identify subclinical right ventricular dysfunction that occurs during cancer treatment, whereas conventional indices of right ventricular dysfunction are not affected. The sensitivity of TAPSE, FAC and the right ventricular Tei index to right ventricular function in this study was lower than that of right ventricular strain parameters.

据报道，纵向应变分析可以识别癌症治疗过程中发生的亚临床右心室功能障碍，而右心室功能障碍的常规指标不受影响。本研究中TAPSE，FAC和右心室Tei指数对右心室功能的敏感性低于右心室应变参数。

This discrepancy is because of the complexity and irregularity of the right ventricular structure and endocardial margins, which limit the two-dimensional ultrasound parameters, TAPSE, and the right ventricular Tei index in evaluating the systolic function of the right ventricle.

这种差异是由于右心室结构和心内膜边缘的复杂性和不规则性，这限制了二维超声参数，TAPSE和右心室Tei指数评估右心室收缩功能。

. TAPSE has a certain angular dependence, and the right ventricular strain parameter detects dysfunction earlier than TAPSE

.TAPSE具有一定的角度依赖性，右心室应变参数比TAPSE更早检测到功能障碍

. Right ventricular strain parameters are strongly correlated with cardiac magnetic resonance right ventricular function and can be used as independent predictors of right ventricular myocardial injury

右心室应变参数与心脏磁共振右心室功能密切相关，可作为右心室心肌损伤的独立预测因子

. Li et al.

李等人。

concluded that Autostrain technology supports semiautomated image analysis, which saves time and produces results comparable to those of traditional methods. Romanowicz et al.

得出的结论是，Autostrain技术支持半自动图像分析，可以节省时间，产生与传统方法相当的结果。Romanowicz等人。

analyzed different versions of the software and concluded that Autostrain is more accurate in measuring strain, reduces operational errors by automatically tracking the endocardium, and saves time by completing the analysis in a few seconds. Li et al.

分析了不同版本的软件，得出结论，Autostrain在测量应变方面更准确，通过自动跟踪心内膜来减少操作误差，并通过在几秒钟内完成分析来节省时间。李等人。

concluded that both fully automated and semiautomated the absolute value of RVFWLS provide rapid and reproducible assessments of RV function and carry important prognostic implication. Moreover, the semiautomated approach performs better than the fully automated method. Therefore, semiautomated the absolute value of RVFWLS can provide a better balance between feasibility and clinical significance and displays potential for clinical application.

得出的结论是，RVFWLS的绝对值全自动和半自动均可提供快速且可重复的RV功能评估，并具有重要的预后意义。此外，半自动化方法的性能优于全自动化方法。因此，半自动化RVFWLS的绝对值可以在可行性和临床意义之间提供更好的平衡，并显示出临床应用的潜力。

Peng et al..

彭等人。。

concluded that the novel semi-automatic strain analysis has the potential to improve efficiency in measurement of longitudinal myocardial strain. Our study used a semi-automated automatic strain technique. Compared with before chemotherapy, the absolute values of RV4CSL and RVFWSL decreased after four cycles of chemotherapy (.

。我们的研究使用了半自动自动应变技术。与化疗前相比，化疗4个周期后RV4CSL和RVFWSL的绝对值下降（。

< 0.05) and further decreased after eight cycles of chemotherapy (

<0.05），并在八个化疗周期后进一步下降(

< 0.01). Compared with after four cycles of chemotherapy, the absolute values of RV4CSL and RVFWSL decreased after eight cycles of chemotherapy (

<0.01）。与化疗4个周期后相比，化疗8个周期后RV4CSL和RVFWSL的绝对值下降(

< 0.05). The absolute values of RV4CSL and RVFWSL may be useful as sensitive indicators reflecting changes in the right ventricular myocardium in the early phase of chemotherapy. No significant difference was observed in TAPSE, FAC and the right ventricular Tei index before chemotherapy compared with after four cycles of chemotherapy or between those after four cycles of chemotherapy and after eight cycles of chemotherapy (.

0.05）。RV4CSL和RVFWSL的绝对值可作为反映化疗早期右心室心肌变化的敏感指标。化疗前TAPSE，FAC和右心室Tei指数与化疗四个周期后或化疗四个周期后和化疗八个周期后相比无显着差异（。

> 0.05). TAPSE and FAC decreased after eight cycles of chemotherapy (

>0.05）。化疗8个周期后TAPSE和FAC下降(

< 0.01), and the right ventricular Tei index increased (

<0.01），右心室Tei指数增加(

< 0.01). TAPSE, FAC and the right ventricular Tei index also reflected changes in the right ventricular myocardium during chemotherapy; however, the changes occurred later than the absolute values of RV4CSL and RVFWSL. Our study also revealed a correlation between the absolute values of RV4CSL, RVFWSL, and right ventricular Tei index, TAPSE and FAC (.

TAPSE，FAC和右心室Tei指数也反映了化疗期间右心室心肌的变化；但是，变化发生的时间晚于RV4CSL和RVFWSL的绝对值。我们的研究还揭示了RV4CSL，RVFWSL的绝对值与右心室Tei指数，TAPSE和FAC（。

< 0.05). Before and after chemotherapy, Pearson’s correlation analysis revealed a correlation between the absolute value of RV4CSL, the absolute value of RVFWSL, right ventricular Tei index, TAPSE and FAC (

Pearson相关分析显示，化疗前后RV4CSL绝对值、RVFWSL绝对值、右心室Tei指数、TAPSE和FAC之间存在相关性(

< 0.05). TAPSE, FAC, and the absolute value of RV4CSL before and after chemotherapy were positively correlated with the absolute value of RVFWSL. Right ventricular Tei index was negatively correlated with the absolute value of RVFWSL. Pearson’s correlation analysis showed a positive correlation between the values of change in TAPSE, FAC, the absolute value of RVFWSL and the absolute value of RV4CSL before and after chemotherapy.

0.05）。化疗前后TAPSE、FAC、RV4CSL绝对值与RVFWSL绝对值呈正相关。右心室Tei指数与RVFWSL绝对值呈负相关。Pearson相关分析显示化疗前后TAPSE，FAC，RVFWSL绝对值和RV4CSL绝对值的变化值呈正相关。

There was a negative correlation between right ventricular Tei index and the absolute value of RV4CSL. The absolute values of RV4CSL and RVFWSL are more reproducible and somewhat overcome the inaccuracy of right ventricular measurements, and the absolute values of RV4CSL and RVFWSL are able to assess myocardial injury earlier and more accurately in patients undergoing anthracycline-based chemotherapy..

右心室Tei指数与RV4CSL绝对值呈负相关。RV4CSL和RVFWSL的绝对值更具可重复性，并在一定程度上克服了右心室测量的不准确性，并且RV4CSL和RVFWSL的绝对值能够更早更准确地评估接受蒽环类化疗的患者的心肌损伤。。

Limitations

限制

The study has some limitations. First, the sample size was small and came from the same hospital. Second, we do not provide comparisons with techniques other than strain measurement, such as cardiac magnetic resonance imaging; Third, we do not have long-term follow-up of breast cancer chemotherapy patients.

这项研究有一些局限性。首先，样本量很小，来自同一家医院。其次，我们不提供与应变测量以外的技术的比较，例如心脏磁共振成像；第三，我们没有对乳腺癌化疗患者进行长期随访。

In future studies, we will conduct long-term follow-up studies on more patients in multi-centers and establish models to promote the development of intelligent ultrasound. Although this study has some limitations, it has contributed to the study of the effects of anthracyclines on the right ventricular myocardium in breast cancer patients..

在未来的研究中，我们将在多中心对更多患者进行长期随访研究，并建立模型以促进智能超声的发展。虽然这项研究有一些局限性，但它有助于研究蒽环类药物对乳腺癌患者右心室心肌的影响。。

Conclusion

结论

Autostrain RV technology helps to detect early impairment of right ventricular myocardial function caused by anthracyclines in patients with breast cancer. The absolute values of RV4CSL and RVFWSL can reflect the effect of anthracyclines on the right ventricular myocardium of patients with breast cancer earlier than TAPSE, FAC and the right ventricular Tei index.

Autostrain RV技术有助于检测蒽环类药物对乳腺癌患者右心室心肌功能的早期损害。RV4CSL和RVFWSL的绝对值可以比TAPSE，FAC和右心室Tei指数更早地反映蒽环类药物对乳腺癌患者右心室心肌的影响。

These parameters are sensitive indicators reflecting the changes in the right ventricular myocardium in the early stage of chemotherapy. Based on the results of this study, we suggest that during chemotherapy for breast cancer, echocardiography should be performed before, during, and at the end of chemotherapy to monitor right ventricular strain parameters, providing an imaging basis for early detection and prevention of right ventricular myocardial injury in clinical practice..

这些参数是反映化疗早期右心室心肌变化的敏感指标。根据这项研究的结果，我们建议在乳腺癌化疗期间，应在化疗前，化疗期间和化疗结束时进行超声心动图检查，以监测右心室应变参数，为临床实践中早期发现和预防右心室心肌损伤提供影像学依据。。

Fig. 1

图1

Time of case data collection.

病例数据收集时间。

Full size image

全尺寸图像

Fig. 2

图2

Measurement of right ventricular TAPSE.

右心室TAPSE的测量。

Full size image

全尺寸图像

Fig. 3

图3

Measurement of right ventricular FAC.

右心室FAC的测量。

Full size image

全尺寸图像

Fig. 4

图4

Measurement of right ventricular Tei Index

右心室Tei指数的测量

Full size image

全尺寸图像

Fig. 5

图5

Autostrain RV technology automatically identifies right ventricular diastolic and systolic periods

Autostrain RV技术自动识别右心室舒张期和收缩期

Full size image

全尺寸图像

Fig. 6

图6

Autostrain RV technology automatically analyzes RVFWSL and RV4CSL

Autostrain RV技术自动分析RVFWSL和RV4CSL

Full size image

全尺寸图像

Fig. 7

图7

Absolute value of RVFWSL result graph (* represents

RVFWSL结果图的绝对值（*表示

<0.05, **** represents

<0.05，****表示

<0.01)

Full size image

全尺寸图像

Fig. 8

图8

Absolute value of RV4CSL result graph (* represents

RV4CSL结果图的绝对值（*表示

<0.05, **** represents

<0.05，****表示

<0.01)

Full size image

全尺寸图像

Fig. 9

图9

TAPSE result graph (** represents

TAPSE结果图（**表示

< 0.01, ns represents meaningless).

<0.01，ns代表无意义）。

Full size image

全尺寸图像

Fig. 10

图10

Tei index result graph (** represents

Tei索引结果图（**表示

< 0.01, ns represents meaningless).

<0.01，ns代表无意义）。

Full size image

全尺寸图像

Fig. 11

图11

FAC result graph(*** represents

FAC结果图（***表示

< 0.01, ns represents meaningless). (

<0.01，ns代表无意义）。(

Note

注释

: T0 represents before chemotherapy, T4 represents after 4 cycles of chemotherapy, and T8 represents after 8 cycles of chemotherapy).

：T0代表化疗前，T4代表化疗4个周期后，T8代表化疗8个周期后）。

Full size image

全尺寸图像

Data availability

数据可用性

All data generated or analysed during this study are included in this published article (and its Supplementary Information files).

本研究期间生成或分析的所有数据均包含在本文（及其补充信息文件）中。

Abbreviations

缩写

RV:

Right ventricular

右心室

RV4CSL:

RV4CSL：

Right ventricular global longitudinal strain

右心室整体纵向应变

RVFWSL:

RVFWSL：

Right ventricular free-wall longitudinal strain

右心室游离壁纵向应变

TAPSE:

TAPSE：

Tricuspidannular plane systolic excursion

三尖瓣环平面收缩期偏移

FAC:

FAC：

Fractional area change

分数面积变化

3D-STI:

3D-STI：

Three-dimensional speckle tracking imaging technology

三维散斑跟踪成像技术

References

参考文献

Calle, M. C. A. et al. Two-dimensional speckle tracking echocardiography predicts early subclinical cardiotoxicity associated with anthracycline-trastuzumab chemotherapy in patients with breast cancer.

二维斑点追踪超声心动图预测乳腺癌患者蒽环类曲妥珠单抗化疗相关的早期亚临床心脏毒性。

BMC Cancer

BMC癌症

(1), 1037 (2018).

Article

文章

CAS

中科院

Google Scholar

谷歌学者

Laursen, A. H. et al.

Laursen，A.H.等。

123

I-MIBG imaging for detection of anthracycline-induced cardiomyopathy.

I-MIBG成像用于检测蒽环类药物引起的心肌病。

Clin. Physiol. Funct. Imaging

临床。生理学。函数。成像

(2), 176–185 (2018).

Article

文章

MathSciNet

MathSciNet 的

PubMed

Google Scholar

谷歌学者

Zamorano, J. L. et al. 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC committee for practice guidelines.

Zamorano，J.L.等人，2016年ESC关于癌症治疗和心血管毒性的立场文件，由ESC实践指南委员会主持制定。

Eur. Heart J.

Eur.心脏J。

(36), 2768–2801 (2016).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Fallah-Rad, N. et al. The utility of cardiac biomarkers, tissue velocity and strain imaging, and cardiac magnetic resonance imaging in predicting early left ventricular dysfunction in patients with human epidermal growth factor receptor II–positive breast cancer treated with adjuvant trastuzumab therapy.

。

J. Am. Coll. Cardiol.

J、美国科罗拉多州。心脏病。

(22), 2263–2270 (2011).

Article

文章

CAS

中科院

PubMed

MATH

数学

Google Scholar

谷歌学者

Wang, Y. et al. 3D-STI evaluation of the effect of dexrazoxane on the mechanical properties of right ventricular myocardium in breast cancer patients treated with pirarubicin.

Wang，Y。等。3D-STI评估右雷佐生对吡柔比星治疗的乳腺癌患者右心室心肌力学性能的影响。

Ann. Palliat. Med.

安，帕莉亚特。和。

(3), 1187–1197 (2020).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Zheng, Q. & Ren, W. Application of the autostrain RV technique in the evaluation of right ventricular systolic function in patients with systemic lupus erythematosus.

Zheng，Q。＆Ren，W。autostrain RV技术在系统性红斑狼疮患者右心室收缩功能评估中的应用。

J. China Med. Univ.

J、中国医科大学。

(10), 940–943 (2022).

MATH

数学

Google Scholar

谷歌学者

Lang, R. M. et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American society of echocardiography and the European association of cardiovascular imaging.

Lang，R.M.等人，《成人超声心动图定量心腔的建议：美国超声心动图学会和欧洲心血管成像协会的最新进展》。

Eur. Heart J. Cardiovasc. Imaging

欧洲心脏杂志Cardiovasc。成像

(3), 233–271 (2015).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Kaul, S., Tei, C., Hopkins, J. M. & Shah, P. M. Assessment of right ventricular function using two-dimensional echocardiography.

Kaul，S.，Tei，C.，Hopkins，J.M。＆Shah，P.M。使用二维超声心动图评估右心室功能。

Am. Heart J.

。

107

(3), 526–531 (1984).

Article

文章

CAS

中科院

PubMed

Google Scholar

谷歌学者

Bennett, S. et al. The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: A systematic review.

Bennett，S.等人。Tei指数在评估蒽环类化疗心脏毒性中的作用：系统评价。

Echo Res. Pract.

Echo Res。

(1), R1–R11 (2021).

（1），R1-R11（2021年）。

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Yu, A. F. & Ky, B. Roadmap for biomarkers of cancer therapy cardiotoxicity.

Yu，A.F。＆Ky，B。癌症治疗心脏毒性生物标志物的路线图。

Heart

心脏

102

(6), 425–430 (2016).

Article

文章

CAS

中科院

PubMed

MATH

数学

Google Scholar

谷歌学者

Awadalla, M. et al. Global longitudinal strain and cardiac events in patients with immune checkpoint inhibitor-related myocarditis.

Awadalla，M.等人。免疫检查点抑制剂相关性心肌炎患者的全球纵向应变和心脏事件。

J. Am. Coll. Cardiol.

J、美国科罗拉多州。心脏病。

(5), 467–478 (2020).

Article

文章

CAS

中科院

PubMed

PubMed Central

公共医学中心

MATH

数学

Google Scholar

谷歌学者

Baruah, A., Hazarika, R. A., Barman, N. N., Islam, S. & Gulati, B. R. Mosquito abundance and pig seropositivity as a correlate of Japanese encephalitis in human population in Assam, India.

。

J. Vector Borne Dis.

J、媒介传播疾病。

(4), 291–296 (2018).

Article

文章

PubMed

Google Scholar

谷歌学者

Nicolazzi, M. A. et al. Anthracycline and trastuzumab-induced cardiotoxicity in breast cancer

Nicolazzi，M.A.等人蒽环类药物和曲妥珠单抗在乳腺癌中引起的心脏毒性

(7), 2175–2185 (2018).

Jain, D. & Aronow, W. Cardiotoxicity of cancer chemotherapy in clinical practice.

Jain，D。＆Aronow，W。癌症化疗在临床实践中的心脏毒性。

Hosp. Pract.

霍斯普。

(1), 6–15 (2018).

Article

文章

MATH

数学

Google Scholar

谷歌学者

Chung, W-B. & Youn, H-J. Pathophysiology and preventive strategies of anthracycline-induced cardiotoxicity.

Chung，W-B。＆Youn，H-J。蒽环类药物引起的心脏毒性的病理生理学和预防策略。

Korean J. Intern. Med.

韩国J.实习生。医学。

(4), 625–633 (2016).

Article

文章

CAS

中科院

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Chang, H-M., Moudgil, R., Scarabelli, T., Okwuosa, T. M. & Yeh, E. T. H. Cardiovascular complications of cancer therapy.

。

J. Am. Coll. Cardiol.

J、美国科罗拉多州。心脏病。

(20), 2536–2551 (2017).

Article

文章

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Angsutararux, P., Luanpitpong, S. & Issaragrisil, S. Chemotherapy-induced cardiotoxicity: Overview of the roles of oxidative stress.

Angsutararux，P.，Luanpitpong，S。和Issaragrisil，S。化疗引起的心脏毒性：氧化应激作用的概述。

Oxidative Med. Cell. Longev.

氧化医学细胞。隆格夫。

2015

, 795602 (2015).

Article

文章

Google Scholar

谷歌学者

Fogarassy, G., Vathy-Fogarassy, Á., Kenessey, I., Kásler, M. & Forster, T. Risk prediction model for long-term heart failure incidence after epirubicin chemotherapy for breast cancer—A real-world data-based, nationwide classification analysis.

福加拉西，G.，瓦西·福加拉西，Á。，Kenessey，I.，Kásler，M。＆Forster，T。乳腺癌表柔比星化疗后长期心力衰竭发生率的风险预测模型-基于现实世界数据的全国分类分析。

Int. J. Cardiol.

国际心脏病杂志。

285

, 47–52 (2019).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Larsen, C. M. & Mulvagh, S. L. Cardio-oncology: What you need to know now for clinical practice and echocardiography.

Larsen，C.M。和Mulvagh，S.L。心脏肿瘤学：临床实践和超声心动图现在需要知道什么。

Echo Res. Pract.

Echo Res。

(1), R33–R41 (2017).

（1），R33–R41（2017）。

Article

文章

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Perez, I. E., Taveras Alam, S., Hernandez, G. A. & Sancassani, R. Cancer therapy-related cardiac dysfunction: An overview for the clinician.

Perez，I.E.，Taveras Alam，S.，Hernandez，G.A。和Sancassani，R。癌症治疗相关的心脏功能障碍：临床医生概述。

Clin. Med. Insights Cardiol.

临床。医学见解心脏病学。

, 1179546819866445 (2019).

Article

文章

PubMed

PubMed Central

PubMed 中央

Google Scholar

谷歌学者

Seicean, S. et al. Cardioprotective effect of β-adrenoceptor blockade in patients with breast cancer undergoing chemotherapy.

Seicean，S.等人。β-肾上腺素能受体阻滞剂对接受化疗的乳腺癌患者的心脏保护作用。

Circulation: Heart Fail.

循环：心脏衰竭。

(3), 420–426 (2013).

Article

文章

CAS

中科院

PubMed

Google Scholar

谷歌学者

Tanindi, A. et al. Assessment of right ventricular functions during cancer chemotherapy.

Tanindi，A。等人。癌症化疗期间右心室功能的评估。

Eur. J. Echocardiogr.

EUR.J.心脏科医生。

(11), 834–840 (2011).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Vitarelli, A. & Terzano, C. Do we have two hearts? New insights in right ventricular function supported by myocardial imaging echocardiography.

维塔雷利，A。和泰萨诺，C。我们有两颗心吗？心肌成像超声心动图支持右心室功能的新见解。

Heart Fail. Rev.

心脏衰竭。版次：。

(1), 39–61 (2009).

Article

文章

Google Scholar

谷歌学者

Cameli, M., Righini, F. M., Lisi, M. & Mondillo, S. Right ventricular strain as a novel approach to analyze right ventricular performance in patients with heart failure.

Cameli，M.，Righini，F.M.，Lisi，M。＆Mondillo，S。右心室应变作为分析心力衰竭患者右心室功能的新方法。

Heart Fail. Rev.

心脏衰竭。版次：。

(5), 603–610 (2013).

Article

文章

Google Scholar

谷歌学者

Li, Y., Zhou, W., Wang, C., Jiao, X. & Wang, M. Reproducibility of the new echocardiography technology for evaluate the left ventricular function.

Li，Y.，Zhou，W.，Wang，C.，Jiao，X.＆Wang，M.用于评估左心室功能的新超声心动图技术的可重复性。

Clin. J. Med. Officers

克林J. Med. 军官

(11), 1271–1274 (2020).

MATH

数学

Google Scholar

谷歌学者

Keramida, K. et al. Longitudinal changes of right ventricular deformation mechanics during trastuzumab therapy in breast cancer patients.

Keramida，K。等人。乳腺癌患者曲妥珠单抗治疗期间右心室变形力学的纵向变化。

Eur. J. Heart Fail.

Eur.J.心脏衰竭。

(4), 529–535 (2019).

Article

文章

CAS

中科院

PubMed

Google Scholar

谷歌学者

Gu, J. et al. Assessment of global cardiac function using AutoSTRAIN automatic strain quantitative technology in patients with breast cancer undergoing anthracycline-based chemotherapy.

Gu，J.等人。使用AutoSTRAIN自动应变定量技术评估接受蒽环类化疗的乳腺癌患者的整体心功能。

Ultrasound Med. Biol.

超声波医学生物学。

(1), 368–374 (2023).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Grover, S. et al. Left and right ventricular effects of anthracycline and trastuzumab chemotherapy: A prospective study using novel cardiac imaging and biochemical markers.

Grover，S.等人。蒽环类和曲妥珠单抗化疗的左心室和右心室效应：使用新型心脏成像和生化标志物的前瞻性研究。

Int. J. Cardiol.

国际心脏病杂志。

168

(6), 5465–5467 (2013).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Murninkas, D. et al. Right ventricular function and prognosis in stable heart failure patients.

Murninkas，D。等人。稳定型心力衰竭患者的右心室功能和预后。

J. Card. Fail.

J、卡片。失败。

(5), 343–349 (2014).

Article

文章

PubMed

Google Scholar

谷歌学者

Zhang, P., Lu, G., Huang, L. & Dong, S. Evaluation of the cardiac function in patients with breast cancer before and after receiving anthracycline by three-dimensional speckle tracking imaging.

Zhang，P.，Lu，G.，Huang，L。＆Dong，S。通过三维斑点追踪成像评估接受蒽环类药物治疗前后乳腺癌患者的心脏功能。

Chin. J. Ultrasonography

下巴。J、超声波检查

(1), 17–20 (2017).

CAS

中科院

Google Scholar

谷歌学者

Cherata, D. A. et al. Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular function in patients with cancer therapy-related left ventricular dysfunction.

Cherata，D.A.等人。纵向应变分析可以确定癌症治疗相关左心室功能障碍患者右心室功能的亚临床恶化。

Discoveries

发现

(2) (2019).

Xu, H., Mao, L., Liu, H., Lin, Z. & Yang, J. Evaluation of early ventricular systolic dysfunction in breast cancer patients treated with anthracycline chemotherapy by three-dimensional speckle tracking imaging Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease. ;

Xu，H.，Mao，L.，Liu，H.，Lin，Z.＆Yang，J.通过三维斑点追踪成像评估蒽环类化疗治疗的乳腺癌患者的早期心室收缩功能障碍中国中西医结合杂志心脑血管疾病；

(3):515–519. (2023).

Wang, Y. et al. Evaluation of changes in right ventricular myocardial mechanical properties in breast cancer patients receiving pirarubicin using three-dimensional speckle tracking imaging.

Wang，Y.等人。使用三维斑点追踪成像评估接受吡柔比星治疗的乳腺癌患者右心室心肌力学特性的变化。

J. South. Med. Univ.

J、南方。医科大学。

(9), 1032–1038 (2018).

ADS

CAS

中科院

MATH

数学

Google Scholar

谷歌学者

Focardi, M. et al. Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparison with cardiac magnetic resonance.

Focardi，M.等人。与心脏磁共振相比，用于分析右心室功能的传统和创新超声心动图参数。

Eur. Heart J. Cardiovasc. Imaging

欧洲心脏杂志Cardiovasc。成像

(1), 47–52 (2014).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Li, L. et al. Machine learning-enabled fully automated assessment of left ventricular volume, ejection fraction and strain: experience in pediatric and young adult echocardiography.

Li，L.等人。机器学习能够全自动评估左心室容积，射血分数和应变：儿科和年轻成人超声心动图的经验。

Pediatr. Cardiol.

儿科。心脏病。

(2022).

Romanowicz, J. et al. Pediatric normal values and Z score equations for left and right ventricular strain by two-dimensional speckle-tracking echocardiography derived from a large cohort of healthy children.

Romanowicz，J.等人。来自大量健康儿童的二维斑点追踪超声心动图得出的左右心室应变的儿科正常值和Z评分方程。

J. Am. Soc. Echocardiogr.

(3), 310–323 (2023).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Li, Y. et al. Feasibility, reproducibility, and prognostic value of fully automated measurement of right ventricular longitudinal strain.

Li，Y.等人。全自动测量右心室纵向应变的可行性，可重复性和预后价值。

J. Am. Soc. Echocardiogr.

(6), 609–619 (2022).

Article

文章

PubMed

MATH

数学

Google Scholar

谷歌学者

Peng, G. et al. Feasibility and reproducibility of semi-automated longitudinal strain analysis: A comparative study with conventional manual strain analysis.

Peng，G.等人。半自动纵向应变分析的可行性和再现性：与常规手动应变分析的比较研究。

Cardiovasc. Ultrasound

。超声波

(1), 12 (2023).

Article

文章

PubMed

PubMed Central

PubMed 中央

MATH

数学

Google Scholar

谷歌学者

Download references

下载参考资料

Acknowledgements

致谢

We would like to thank Editage for English language editing.

我们要感谢Editage的英语编辑。

Funding

资金

The present study was funded by Project of Hebei Medical Science Research Plan in 2021.The funding number is 20210831

本研究由2021年河北省医学科学研究计划项目资助。资助号码为20210831

Author information

作者信息

Author notes

作者注释

Yan Liang and Ping Du contributed equally to this work.

阎良和杜平对这项工作做出了同样的贡献。

Authors and Affiliations

作者和隶属关系

Department of Ultrasound Medicine, Zhangjiakou First Hospital, Zhangjiakou, 075000, China

张家口市第一医院超声医学科，张家口075000

Yan Liang & Ping Du

阎亮和杜萍

Department of Ultrasound Medicine, The First Affiliated Hospital of Hebei North University, 12 Changqing Road, Zhangjiakou, 075000, China

河北北方大学第一附属医院超声医学科，张家口市长青路12号，075000

Xinshi Li, Yingying Han, Hongfang Dongye, Hongqiang Liu & Jinqiu Li

Department of Imaging, Zhangjiakou First Hospital, Zhangjiakou, 075000, China

张家口市第一医院影像科，张家口，075000

Yabo Song

歌宝

Department of Radiation Therapy, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China

河北北方大学第一附属医院放射治疗科，张家口，075000

Jinqiu Li

李金秋

Authors

作者

Yan Liang

阎亮（音）

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Ping Du

平度

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Yabo Song

宋雅波

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Xinshi Li

李新世

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Yingying Han

韩迎迎

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Hongfang Dongye

红坊东野

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Hongqiang Liu

刘洪强（音）

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Jinqiu Li

李金秋

View author publications

查看作者出版物

You can also search for this author in

您也可以在中搜索此作者

PubMed

Google Scholar

谷歌学者

Contributions

捐款

YL performed the experiments, prepared figures and/or tables, authored or reviewed drafts of the article, and approved the final draft.(YL and PD : Equal contribution) PD(co-1stauthor) analyzed the data, authored or reviewed drafts of the article, and approved the final draft. YS analyzed the data, prepared figures and/or tables, and approved the final draft.

YL进行了实验，准备了数字和/或表格，撰写或审阅了文章的草稿，并批准了最终草稿。（YL和PD：同等贡献）PD（co-1stauthor）分析了数据，撰写或审阅了文章的草稿，并批准了最终草稿。YS分析了数据，准备了数字和/或表格，并批准了最终草案。

XL performed the experiments, prepared figures and/or tables, and approved the final draft. YH analyzed the data, authored or reviewed drafts of the article, and approved the final draft. HD performed the experiments, prepared figures and/or tables, and approved the final draft. HL conceived and designed the experiments, authored or reviewed drafts of the article, and approved the final draft.

XL进行了实验，准备了数字和/或表格，并批准了最终草案。YH分析了数据，撰写或审阅了文章的草稿，并批准了最终草稿。HD进行了实验，准备了数字和/或表格，并批准了最终草案。HL构思并设计了实验，撰写或审阅了文章的草稿，并批准了最终草稿。

JL Collected cases, and approved the final draft. All authors read and approved the final manuscript..

JL收集了案例，并批准了最终草案。所有作者都阅读并批准了最终稿件。。

Corresponding author

通讯作者

Correspondence to

通信对象

Hongqiang Liu

刘洪强（音）

Ethics declarations

道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Ethics approval and consent to participate

道德批准和同意参与

This study was approved by the Ethics Committee of the First Affiliated Hospital of Hebei North University (k2023004). All patients signed consent forms.

本研究经河北北方大学第一附属医院伦理委员会（k2023004）批准。所有患者均签署了同意书。

Additional information

其他信息

Publisher’s note

出版商注释

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Springer Nature在已发布的地图和机构隶属关系中的管辖权主张方面保持中立。

Electronic supplementary material

电子补充材料

Below is the link to the electronic supplementary material.

以下是电子补充材料的链接。

Supplementary Material 1

Rights and permissions

权限和权限

Open Access

开放存取

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

本文是根据知识共享署名非商业性NoDerivatives 4.0国际许可证授权的，该许可证允许以任何媒介或格式进行任何非商业性使用，共享，分发和复制，只要您对原始作者和来源给予适当的信任，提供知识共享许可证的链接，并指出您是否修改了许可材料。

You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit .

要查看此许可证的副本，请访问。

http://creativecommons.org/licenses/by-nc-nd/4.0/

Reprints and permissions

重印和许可

About this article

关于本文

Cite this article

引用本文

Liang, Y., Du, P., Song, Y.

梁，Y，杜，P，宋，Y。

et al.

等人。

The importance of the Autostrain RV technique in the treatment of right ventricular myocardial alterations in patients with breast cancer receiving chemotherapy.

Autostrain RV技术在治疗接受化疗的乳腺癌患者右心室心肌改变中的重要性。

Sci Rep

Sci代表

, 2765 (2025). https://doi.org/10.1038/s41598-025-87272-5

, 2765 (2025).https://doi.org/10.1038/s41598-025-87272-5

Download citation

下载引文

Received

已接收

05 May 2024

2024年5月5日

Accepted