放射性心脏损伤检测方法的研究进展
Research Progress of Radioactive Heart Injury Detection Methods
DOI: 10.12677/ACM.2023.132225, PDF,   
作者: 马娜娜, 陈 凡*, 赵 兴:青海大学附属医院放疗科,青海 西宁
关键词: 放射治疗心脏损伤心脏毒性检测方法Radiation Therapy Heart Damage Cardiac Toxicity Detection Method
摘要: 放射治疗(RT)作为肿瘤治疗的重要手段之一,极大地提高了乳腺等胸部恶性肿瘤患者的生存率和生存期,同时,对邻近结构的附带损伤导致了不可避免的并发症,严重降低患者的生活质量和生存获益。随着患者生存期的延长,治疗带来的副作用对肿瘤治疗效果及预后的影响越来越突出。近年来,放射性心脏损伤(RIHD)已成为胸部肿瘤放疗患者非肿瘤性死亡的首要原因。RIHD的早期发现和及时干预对肿瘤患者具有重要的临床意义,本文对血清学检测、影像学检查等RIHD检测方法进行简要综述。
Abstract: As one of the important means of tumor treatment, radiotherapy (RT) has greatly improved the survival rate and survival period of patients with breast and other breast malignant tumors. Meanwhile, the collateral damage to adjacent structures leads to inevitable complications, which seriously reduces the quality of life and survival benefits of patients. With the prolongation of pa-tients’ survival time, the side effects of treatment have more and more prominent influence on the efficacy and prognosis of tumor treatment. In recent years, radiation-induced heart injury (RIHD) has become the leading cause of non-neoplastic death in patients treated with radiotherapy for thoracic tumors. Early detection and timely intervention of RIHD have important clinical signifi-cance for tumor patients. This paper briefly reviews the detection methods of RIHD such as serolog-ical detection and imaging examination.
文章引用:马娜娜, 陈凡, 赵兴. 放射性心脏损伤检测方法的研究进展[J]. 临床医学进展, 2023, 13(2): 1629-1635. https://doi.org/10.12677/ACM.2023.132225

参考文献

[1] 郎锦义. 中国放疗三十年回顾、思考与展望[J]. 肿瘤预防与治疗, 2017, 30(1): 1-4+6.
[2] Ellahham, S., Khalouf, A., Elkhazendar, M., et al. (2022) An Overview of Radiation-Induced Heart Disease. Radiation Oncology Journal, 40, 89-102. [Google Scholar] [CrossRef] [PubMed]
[3] Sárközy, M., Varga, Z., Gáspár, R., et al. (2021) Pathomecha-nisms and Therapeutic Opportunities in Radiation-Induced Heart Disease: From Bench to Bedside. Clinical Research in Cardiology, 110, 507-531. [Google Scholar] [CrossRef] [PubMed]
[4] Lancellotti, P., Nkomo, V.T., Badano, L.P., et al. (2013) Expert Consensus for Multi-Modality Imaging Evaluation of Cardiovascular Complications of Radiotherapy in Adults: A Report from the European Association of Cardiovascular Imaging and The American Society of Echocardiography. European Heart Journal. Cardiovascular Imaging, 14, 721-740. [Google Scholar] [CrossRef] [PubMed]
[5] Zhu, Q., Kirova, Y.M., Cao, L., et al. (2018) Cardiotoxicity Associated with Radiotherapy in Breast Cancer: A Question-Based Review with Current Literatures. Cancer Treatment Reviews, 68, 9-15. [Google Scholar] [CrossRef] [PubMed]
[6] 陈情, 李越, 颜若难. 调强放疗对肺癌患者心电图心肌酶谱及b型利钠肽的影响[J]. 中国肿瘤临床, 2020, 47(18): 944-948.
[7] Koutroumpakis, E., Palaskas, N.L., Lin, S.H., et al. (2020) Modern Radiotherapy and Risk of Cardiotoxicity. Chemotherapy, 65, 65-76. [Google Scholar] [CrossRef] [PubMed]
[8] Belzile-Dugas, E. and Eisenberg, M.J. (2021) Radiation‐Induced Cardio-vascular Disease: Review of an Underrecognized Pathology. Journal of the American Heart Association, 10, e021686. [Google Scholar] [CrossRef
[9] Wang, H., Wei, J., Zheng, Q., et al. (2019) Radiation-Induced Heart Disease: A Review of Classification, Mechanism and Prevention. International Journal of Biological Sciences, 15, 2128-2138. [Google Scholar] [CrossRef] [PubMed]
[10] 武霞, 杨清华, 刘学键, 等. 24h动态心电图联合心肌肌钙蛋白ⅰ评价放射性心脏损伤的应用研究[J]. 中华放射肿瘤学杂志, 2020, 29(6): 421-426.
[11] Palumbo, I., Palumbo, B., Fravolini, M.L., et al. (2016) Brain Natriuretic Peptide as a Cardiac Marker of Transient Radiotherapy-Related Dam-age in Left-Sided Breast Cancer Patients: A Prospective Study. Breast (Edinburgh, Scotland), 25, 45-50. [Google Scholar] [CrossRef] [PubMed]
[12] D’Errico, M.P., Petruzzelli, M.F., Gianicolo, E.A.L., et al. (2015) Kinetics of b-Type Natriuretic Peptide Plasma Levels in Patients with Left-Sided Breast Cancer Treated with Radiation Therapy: Results after One-Year Follow-Up. International Journal of Radiation Biology, 91, 804-809. [Google Scholar] [CrossRef] [PubMed]
[13] Skyttä, T., Tuohinen, S., Boman, E., et al. (2015) Troponin t-Release Associates with Cardiac Radiation Doses during Adjuvant Left-Sided Breast Cancer Radiotherapy. Radiation Oncology (London, England), 10, 141. [Google Scholar] [CrossRef] [PubMed]
[14] Tian, S., Hirshfield, K.M., Jabbour, S.K., et al. (2014) Serum Biomarkers for the Detection of Cardiac Toxicity after Chemotherapy and Radiation Therapy in Breast Cancer Patients. Frontiers in Oncology, 4, 277. [Google Scholar] [CrossRef] [PubMed]
[15] Kozak, K.R., Hong, T.S., Sluss, P.M., et al. (2008) Cardiac Blood Biomarkers in Patients Receiving Thoracic (Chemo)radiation. Lung Cancer (Amsterdam, Netherlands), 62, 351-355. [Google Scholar] [CrossRef] [PubMed]
[16] Demissei, B.G., Freedman, G., Feigenberg, S.J., et al. (2019) Early Changes in Cardiovascular Biomarkers with Contemporary Thoracic Radiation Therapy for Breast Cancer, Lung Cancer, and Lymphoma. International Journal of Radiation Oncology, Biology, Physics, 103, 851-860. [Google Scholar] [CrossRef] [PubMed]
[17] Speers, C., Murthy, V.L., Walker, E.M., et al. (2022) Cardiac Magnetic Resonance Imaging and Blood Biomarkers for Evaluation of Radiation-Induced Cardiotoxicity in Patients with Breast Cancer: Results of a Phase 2 Clinical Trial. International Journal of Radiation Oncology Biology Physics, 112, 417-425. [Google Scholar] [CrossRef] [PubMed]
[18] Zeng, Z.-M., Xu, P., Zhou, S., et al. (2020) Positive Association between Heart Dosimetry Parameters and a Novel Cardiac Biomarker, Solublest-2, in Thoracic Cancer Chest Radiation. Journal of Clinical Laboratory Analysis, 34, e23150. [Google Scholar] [CrossRef] [PubMed]
[19] Hawkins, P.G., Sun, Y., Dess, R.T., et al. (2019) Circulating Micrornas as Biomarkers of Radiation-Induced Cardiac Toxicity in Non-Small-Cell Lung Cancer. Journal of Cancer Research and Clinical Oncology, 145, 1635-1643. [Google Scholar] [CrossRef] [PubMed]
[20] Vasbinder, A., et al. (2022) Chronic Oxidative Stress as a Marker of Long-Term Radiation-Induced Cardiovascular Outcomes in Breast Cancer. Journal of Cardiovascular Trans-lational Research.
[21] Marinko, T., Stojanov Konda, J.T., Dolžan, V., et al. (2020) Genetic Variability of Antioxidative Mechanisms and Cardiotoxicity after Adjuvant Radiotherapy in her2-Positive Breast Cancer Patients. Disease Markers, 2020, Article ID: 6645588. [Google Scholar] [CrossRef] [PubMed]
[22] Podlesnikar, T., Berlot, B., Dolenc, J., et al. (2022) Radiotherapy-Induced Cardiotoxicity: The Role of Multimodality Cardiovascular Imaging. Frontiers in Cardio-vascular Medicine, 9, Article ID: 887705. [Google Scholar] [CrossRef] [PubMed]
[23] Frey, M.K. and Bergler-Klein, J. (2021) Echocardiographic Evalua-tion of Patients Undergoing Cancer Therapy. European Heart Journal—Cardiovascular Imaging, 22, 375-382. [Google Scholar] [CrossRef] [PubMed]
[24] 朱天刚. 肿瘤心脏病与超声心动图[J]. 临床心血管病杂志, 2018, 34(10): 939-942.
[25] Quintero-Martinez, J.A., Cordova-Madera, S.N. and Villarraga, H.R. (2021) Radiation-Induced Heart Disease. Journal of Clinical Medicine, 11, 146. [Google Scholar] [CrossRef] [PubMed]
[26] Li, T., Zhuang, H., Wang, Y., et al. (2022) Two-Dimensional Speckle Tracking Echocardiography in Evaluating Radiation-Induced Heart Damage. Asia-Pacific Journal of Oncology Nursing, 9, 119-124. [Google Scholar] [CrossRef] [PubMed]
[27] Zagar, T.M., Cardinale, D.M. and Marks, L.B. (2016) Breast Cancer Therapy-Associated Cardiovascular Disease. Nature Reviews. Clinical Oncology, 13, 172-184. [Google Scholar] [CrossRef] [PubMed]
[28] Charbonnel, C., Convers-Domart, R., Rigaudeau, S., et al. (2017) Assessment of Global Longitudinal Strain at Low- Dose Anthracycline-Based Chemotherapy, for the Prediction of Sub-sequent Cardiotoxicity. European Heart Journal. Cardiovascular Imaging, 18, 392-401. [Google Scholar] [CrossRef] [PubMed]
[29] 杨菲, 陈勇, 张西志, 等. 组织多普勒联合左心房容积指数评价食管癌患者放疗后早期心脏损伤[J]. 中国医学影像技术, 2016, 32(6): 862-865.
[30] Tamborini, G., Piazzese, C., Lang, R.M., et al. (2017) Feasibility and Accuracy of Automated Software for Transthoracic Three-Dimensional Left Ventricu-lar Volume and Function Analysis: Comparisons with Two-Dimensional Echocardiography, Three-Dimensional Trans-thoracic Manual Method, and Cardiac Magnetic Resonance Imaging. Journal of the American Society of Echocardiog-raphy: Official Publication of the American Society of Echocardiography, 30, 1049-1058. [Google Scholar] [CrossRef] [PubMed]
[31] Heidenreich, P.A., Schnittger, I., Strauss, H.W., et al. (2007) Screening for Coronary Artery Disease after Mediastinal Irradiation for Hodgkin’s Disease. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 25, 43-49. [Google Scholar] [CrossRef
[32] Desai, M.Y., Jellis, C.L., Kotecha, R., et al. (2018) Radia-tion-Associated Cardiac Disease: A Practical Approach to Diagnosis and Management. JACC. Cardiovascular Imaging, 11, 1132-1149. [Google Scholar] [CrossRef] [PubMed]
[33] Ar Van, R., et al. (2017) Different Manifestation of Irradiation Induced Coronary Artery Disease Detected with Coronary Computed Tomography Compared with Matched Non-Irradiated Controls. Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radi-ology and Oncology, 125, 55-61. [Google Scholar] [CrossRef] [PubMed]
[34] Gal, R., Van Velzen, S.G.M., Hooning, M.J., et al. (2021) Iden-tification of Risk of Cardiovascular Disease by Automatic Quantification of Coronary Artery Calcifications on Radio-therapy Planning CT Scans in Patients with Breast Cancer. JAMA Oncology, 7, 1024-1032. [Google Scholar] [CrossRef] [PubMed]
[35] Groarke, J.D., Nguyen, P.L., Nohria, A., et al. (2014) Cardio-vascular Complications of Radiation Therapy for Thoracic Malignancies: The Role for Non-Invasive Imaging for Detec-tion of Cardiovascular Disease. European Heart Journal, 35, 612-623. [Google Scholar] [CrossRef] [PubMed]
[36] Kramer, C.M., Barkhausen, J., Bucciarelli-Ducci, C., et al. (2020) Standardized Cardiovascular Magnetic Resonance Imaging (CMR) Protocols: 2020 Update. Journal of Cardiovascular Magnetic Resonance: Official Journal of the Society for Cardiovascular Magnetic Resonance, 22, 17. [Google Scholar] [CrossRef] [PubMed]
[37] Van Der Velde, N., Janus, C.M., Bowen, D.J., et al. (2021) De-tection of Subclinical Cardiovascular Disease by Cardiovascular Magnetic Resonance in Lymphoma Survivors. JACC. CardioOncology, 3, 695-706. [Google Scholar] [CrossRef] [PubMed]
[38] Eftekhari, M., Anbiaei, R., Zamani, H., et al. (2015) Radia-tion-Induced Myocardial Perfusion Abnormalities in Breast Cancer Patients Following External Beam Radiation Therapy. Asia Oceania Journal of Nuclear Medicine & Biology, 3, 3-9.
[39] Abraham, A., Sanghera, K.P., Gheisari, F., et al. (2022) Is Radiation-Induced Cardiac Toxicity Reversible? Prospective Evaluation of Patients with Breast Cancer Enrolled in a Phase 3 Randomized Controlled Trial. International Journal of Radiation Oncology, Biology, Physics, 113, 125-134. [Google Scholar] [CrossRef] [PubMed]
[40] Polomski, E.-A.S., Antoni, M.L., Jukema, J.W., et al. (2022) Nuclear Medicine Imaging Methods of Radiation-Induced Cardiotoxicity. Seminars in Nuclear Medicine, 52, 597-610. [Google Scholar] [CrossRef] [PubMed]
[41] Rasmussen, T., Kjær, A., Lassen, M.L., et al. (2021) No Changes in Myocardial Perfusion Following Radiation Therapy of Left-Sided Breast Cancer: A Positron Emission To-mography Study. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology, 28, 1923-1932. [Google Scholar] [CrossRef] [PubMed]
[42] Sciagrà, R., Lubberink, M., Hyafil, F., et al. (2021) EANM Procedural Guidelines for PET/CT Quantitative Myocardial Perfusion Imaging. European Journal of Nuclear Medicine and Molecular Imaging, 48, 1040-1069. [Google Scholar] [CrossRef] [PubMed]
[43] Żyromska, A., Małkowski, B., Wiśniewski, T., et al. (2018) 15O-H2O PET/CT as a Tool for the Quantitative Assessment of Early Post-Radiotherapy Changes of Heart Perfusion in Breast Carcinoma Patients. The British Journal of Radiology, 91, Article ID: 20170653. [Google Scholar] [CrossRef] [PubMed]
[44] Song, J., Yan, R., Wu, Z., et al. (2017) 13N-Ammonia PET/CT Detec-tion of Myocardial Perfusion Abnormalities in Beagle Dogs after Local Heart Irradiation. Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine, 58, 605-610. [Google Scholar] [CrossRef] [PubMed]
[45] 高丽, 张洪明, 李险峰. 放射性心脏损伤诊断方法的研究进展[J]. 国际放射医学核医学杂志, 2020(2): 109-113.
[46] Plana, J.C., Thavendiranathan, P., Bucciarelli-Ducci, C., et al. (2018) Multi-Modality Imaging in the As-sessment of Cardiovascular Toxicity in the Cancer Patient. JACC. Cardiovascular Imaging, 11, 1173-1186. [Google Scholar] [CrossRef] [PubMed]
[47] Yan, R., Song, J., Wu, Z., et al. (2015) Detection of Myocardial Metabolic Abnormalities by 18f-fdg PET/CT and Corresponding Pathological Changes in Beagles with Local Heart Irra-diation. Korean Journal of Radiology, 16, 919-928. [Google Scholar] [CrossRef] [PubMed]
[48] El-Sherif, O., Xhaferllari, I., Sykes, J., et al. (2019) [18F]fdg Car-diac PET Imaging in a Canine Model of Radiation- Induced Cardiovascular Disease Associated with Breast Cancer Radi-otherapy. American Journal of Physiology. Heart and Circulatory Physiology, 316, H586-H595. [Google Scholar] [CrossRef] [PubMed]
[49] Manabe, O., Oyama-Manabe, N. and Tamaki, N. (2020) Positron Emission Tomography/MRI for Cardiac Diseases Assessment. The British Journal of Radiology, 93, Article ID: 20190836. [Google Scholar] [CrossRef] [PubMed]