CBS 2019
CBSMD教育中心
中 文

急性冠脉综合征

Abstract

Recommended Article

2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Association between Coronary Collaterals and Myocardial Viability in Patients with a Chronic Total Occlusion Implications of Alternative Definitions of Peri-Procedural Myocardial Infarction After Coronary Revascularization Relationship between therapeutic effects on infarct size in acute myocardial infarction and therapeutic effects on 1-year outcomes: A patient-level analysis of randomized clinical trials Impact of tissue protrusion after coronary stenting in patients with ST-segment elevation myocardial infarction Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry Optimum Blood Pressure in Patients With Shock After Acute Myocardial Infarction and Cardiac Arrest

Review Article2018 Jul 19. [Epub ahead of print]

JOURNAL:Curr Opin Cardiol. Article Link

Applications of left ventricular strain measurements to patients undergoing chemotherapy

Clasen SC, Scherrer-Crosbie M. Keywords: LVEF; cancer therapy-related cardiotoxicity; global longitudinal strain; early detection; treatment; prevention

ABSTRACT


PURPOSE OF REVIEW - We aim to summarize the utility of strain in monitoring the effects of cancer therapy-related cardiotoxicity (CTRC) on the development of left ventricular (LV) dysfunction.


RECENT FINDINGS - Serial assessment of cardiac function at baseline and during treatment is recommended in patients undergoing cancer treatment. Historically, the use of left ventricular ejection fraction (LVEF) has been used to monitor for cardiac toxicity from cancer therapies but myocardial mechanic parameters, in particular global longitudinal strain (GLS), have emerged as powerful adjunctive tools. On the basis of longitudinal cohort studies in patients treated with anthracyclines and trastuzumab and retrospective studies of childhood survivors of cancers, strain has been used to detect subclinical LV dysfunction prior to changes in LVEF. Strain parameters decrease during both anthracycline and trastuzumab and these changes can persist after completion of therapy. Baseline GLS and changes in GLS during therapy can be independently prognostic for developing CTRC. Further, GLS has appeared to have an additive predictive value in addition to the traditional clinical parameters and baseline LVEF in the development of cardiotoxicity. The inclusion of strain parameters in clinical decision making and therapeutic planning is an area of intense research.

SUMMARY - This review seeks to highlight the importance of echocardiographic strain measurements in early detection, treatment and prevention of LV dysfunction from CTRC.