Một số ảnh hưởng trên chức năng thất trái ở các bệnh nhân ghép tế bào gốc điều trị bệnh máu ác tính
Nội dung chính của bài viết
Tóm tắt
Hiện nay ung thư và các bệnh máu ác tính đang có xu hướng ngày càng gia tăng. Sự ra đời của phương pháp điều trị ghép tế bào gốc tạo máu cùng với sự phát triển của hóa trị liệu đã mang lại cơ hội sống cho nhiều bệnh nhân mắc bệnh máu ác tính nhưng đồng thời cũng làm gia tăng gánh nặng bệnh tật do tác dụng phụ của hóa trị liệu trong đó có bệnh lý tim mạch. Nghiên cứu của chúng tôi sử dụng phương pháp siêu âm tim 2D nhằm đánh giá chức năng thất trái ở các bệnh nhân này. Kết quả cho thấy, phân số tống máu thất trái và sức căng cơ tim toàn bộ theo chiều dọc giảm ở thời điểm sau ghép tế bào gốc 1 tháng (khác biệt có ý nghĩa thống kê, p < 0,05) và có sự hồi phục ở thời điểm sau ghép TBG 3 tháng. Vận tốc sóng E, tỷ lệ E/A, và vận tốc sóng e’ bên giảm sau ghép 1 tháng (khác biệt có ý nghĩa thống kê, p < 0,05).
Chi tiết bài viết
Từ khóa
ghép tế bào gốc tạo máu, siêu âm tim 2-D, đánh dấu mô cơ tim, nhiễm độc cơ tim
Tài liệu tham khảo
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11. Tuzovic M, Mead M, Young PA, Schiller G, Yang EH. Cardiac Complications in the Adult Bone Marrow Transplant Patient. Current oncology reports. Mar 2 2019;21(3):28. doi:10.1007/s11912-019-0774-6.
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14. Hertenstein B, Stefanic M, Schmeiser T, et al. Cardiac toxicity of bone marrow transplantation: predictive value of cardiologic evaluation before transplant. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. May 1994;12(5):998-1004. doi:10.1200/jco.1994.12.5.998.
15. Pasvolsky O, Morelli O, Rozovski U, et al. Anthracycline-Induced Cardiotoxicity in Acute Myeloid Leukemia Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation. Clinical lymphoma, myeloma & leukemia. Mar 11 2019;doi:10.1016/j.clml.2019.03.007.
16. Paraskevaidis IA, Makavos G, Tsirigotis P, et al. Deformation Analysis of Myocardial Layers Detects Early Cardiac Dysfunction after Chemotherapy in Bone Marrow Transplantation Patients: A Continuous and Additive Cardiotoxicity Process. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. Nov 2017;30(11):1091-1102. doi:10.1016/j.echo.2017.07.010.
2. Copelan EA. Hematopoietic Stem-Cell Transplantation. New England Journal of Medicine. 2006; 354(17):1813-1826. doi:10.1056/NEJMra052638.
3. Bhatia S, Francisco L, Carter A, et al. Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood. Nov 15 2007;110(10):3784-92. doi:10.1182/blood-2007-03-082933.
4. Bhatia S, Robison LL, Francisco L, et al. Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the Bone Marrow Transplant Survivor Study. Blood. Jun 1 2005;105(11):4215-22. doi:10.1182/blood-2005-01-0035.
5. Majhail NS, Rizzo JD, Lee SJ, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. Mar 2012;18(3):348-71. doi:10.1016/j.bbmt.2011.12.519.
6. Lang RM, Badano LP, Mor-Avi V, 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. Eur Heart J Cardiovasc Imaging. Mar 2015;16(3):233-70. doi:10.1093/ehjci/jev014.
7. Plana JC, Galderisi M, Barac A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2014;15(10):1063-1093. doi:10.1093/ehjci/jeu192.
8. Zamorano JL, Lancellotti P, Rodriguez Munoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). European journal of heart failure. Jan 2017;19(1):9-42. doi:10.1002/ejhf.654.
9. Poreba M, Gac P, Usnarska-Zubkiewicz L, et al. Echocardiographic evaluation of the early cardiotoxic effect of hematopoietic stem cell transplantation in patients with hematologic malignancies. Leukemia & lymphoma. Sep 2016;57(9):2119-25. doi:10.3109/10428194.2015.1122782.
10. Fujimaki K, Maruta A, Yoshida M, et al. Severe cardiac toxicity in hematological stem cell transplantation: predictive value of reduced left ventricular ejection fraction. Bone marrow transplantation. Feb 2001;27(3):307-10. doi:10.1038/sj.bmt.1702783.
11. Tuzovic M, Mead M, Young PA, Schiller G, Yang EH. Cardiac Complications in the Adult Bone Marrow Transplant Patient. Current oncology reports. Mar 2 2019;21(3):28. doi:10.1007/s11912-019-0774-6.
12. Swain SM, Whaley FS, Ewer MS. Congestive heart failure in patients treated with doxorubicin: a retrospective analysis of three trials. Cancer. Jun 1 2003;97(11):2869-2879. doi:10.1002/cncr.11407.
13. Curigliano G LD, Fradley M, et al. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol. 2020;31(2):171-190. doi:10.1016/j.annonc.2019.10.023.
14. Hertenstein B, Stefanic M, Schmeiser T, et al. Cardiac toxicity of bone marrow transplantation: predictive value of cardiologic evaluation before transplant. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. May 1994;12(5):998-1004. doi:10.1200/jco.1994.12.5.998.
15. Pasvolsky O, Morelli O, Rozovski U, et al. Anthracycline-Induced Cardiotoxicity in Acute Myeloid Leukemia Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation. Clinical lymphoma, myeloma & leukemia. Mar 11 2019;doi:10.1016/j.clml.2019.03.007.
16. Paraskevaidis IA, Makavos G, Tsirigotis P, et al. Deformation Analysis of Myocardial Layers Detects Early Cardiac Dysfunction after Chemotherapy in Bone Marrow Transplantation Patients: A Continuous and Additive Cardiotoxicity Process. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. Nov 2017;30(11):1091-1102. doi:10.1016/j.echo.2017.07.010.