多模态超声评估乳腺癌双靶向治疗后右室功能
Multimodality Echocardiographic Assessment of Right Ventricular Function after Dual-Targeted Therapy for Breast Cancer
DOI: 10.12677/acm.2026.1682836, PDF,   
作者: 谢 丽, 程 娟, 龚朝耕:赣南医科大学第一临床医学院,江西 赣州;廖福顺:赣州市人民医院超声医学科,江西 赣州;陈卫华*:赣南医科大学第一附属医院超声医学科,江西 赣州
关键词: 乳腺癌;人表皮生长因子受体2;靶向治疗;右心室功能;超声心动图;肿瘤治疗相关心脏功能障碍;Breast Cancer; Human Epidermal Growth Factor Receptor 2; Targeted Therapy; Right Ventricular Function; Echocardiography; Cancer Therapy-Related Cardiac Dysfunction
摘要: 人类表皮生长因子受体2 (Human epidermal growth factor receptor 2, HER2)阳性乳腺癌侵袭性强,以曲妥珠单抗、帕妥珠单抗为核心的TCbHP方案(紫杉类 + 卡铂 + 曲妥珠单抗 + 帕妥珠单抗)显著改善了患者预后,但治疗相关心脏毒性成为影响长期生存的重要问题。既往监测多聚焦于左心室射血分数,对右心室关注不足,而右心室损伤往往隐匿且可能早于左心室出现。本文阐述靶向药物及化疗的协同心脏毒性机制,重点评述单一技术(常规超声、斑点追踪成像、四维右室容积定量)及四维右室容积定量联合斑点追踪成像技术在右心室功能早期评估中的价值与整合策略,以期实现肿瘤治疗与心脏保护的双重目标。
Abstract: Human epidermal growth factor receptor 2 (Human epidermal growth factor receptor 2, HER2)-positive breast cancer is highly aggressive, accounting for 15%~20% of all breast cancers. Dual HER2 blockade with trastuzumab and pertuzumab combined with taxane- and carboplatin-based chemotherapy (TCbHP) has markedly improved survival. Cancer therapy-related cardiac dysfunction (CTRCD) has become a critical issue. Traditional surveillance focuses on left ventricular ejection fraction, while the right ventricle (RV) is often overlooked. This review addresses mechanisms of RV injury and the value of multimodality echocardiography—including conventional indices, speckle-tracking strain, four-dimensional volumetric quantification, and 4D-RV-Volume combined with speckle-tracking imaging (STI)—in early detection of subclinical RV dysfunction.
文章引用:谢丽, 程娟, 龚朝耕, 廖福顺, 陈卫华. 多模态超声评估乳腺癌双靶向治疗后右室功能[J]. 临床医学进展, 2026, 16(8): 641-648. https://doi.org/10.12677/acm.2026.1682836

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