Phase analysis of gated myocardial perfusion imaging for early diagnosis of cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in pa-tients with diffuse large B-cell lymphoma ( DLBCL) . Methods Thirty-two patients ( 22 males, 10 females, age:22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume ( LVEDV) , left ventricular end-systolic volume ( LVESV) , peak filling rate ( PFR) , summed motion score ( SMS) and summed thickening score ( STS) as well as left ventricular systolic synchrony indicators including phase bandwidth ( BW) , phase standard deviation ( SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis. Results Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8. 68)°;SD:(11.65±4.64)° vs (8.79±3.14)°;entropy:(39.84±5.51)％ vs (36.19±5.94)％;t values: -9.132 to-3.173, all P<0.05) . There were no significant differences in other indicators ( t values:-1.161 to 1.750, z values:-1.633 to-0.096, all P>0.05). Of 32 patients, 13 patients (40.62％) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchro-ny was significantly higher than that of left ventricular dysfunction (15.62％, 5/32;χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssyn-chrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)％ vs (66.79±7.65)％;t=4.087, P<0.01) . Conclusion Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indi-cator of cardiotoxicity caused by anthracycline chemotherapy.