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      Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in patients with diffuse large B-cell lymphoma

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          Abstract

          Anthracycline chemotherapy is commonly used in the treatment of diffuse large B-cell lymphoma (DLBCL). Treatment-related cardiotoxicity (TRC) is defined as when the patient is identified to have one of the following clinical manifestations: Symptomatic heart failure, cardiac death, arrhythmia, infarction, a decrease in left ventricular ejection fraction (LVEF) of >15% from baseline or a decrease in LVEF of >10 to <50%. TRC may induce severe cardiac failure or cardiac arrhythmia as the main cause of death. The present study aimed to investigate the prognostic value of the summed rest score (SRS) in gated myocardial perfusion imaging (G-MPI) for the early detection of TRC caused by anthracycline chemotherapy in patients with DLBCL. A total of 36 DLBCL patients were enrolled in the present study, and a series of parameters were compared at baseline and after chemotherapy. According to the occurrence of TRC during the observation period, the patients were divided into two groups, and parameters associated with cardiac function were compared. The SRS in G-MPI and the corrected QT interval in the electrocardiogram were significantly different before and after chemotherapy (P=0.012 and P=0.015, respectively). By comparing parameters associated with cardiac function between the TRC group (n=22) and the no-TRC group (n=14), it was found that only SRS was significantly different (P=0.012). Multivariate logistic regression analysis showed that the SRS level was the only independent predicator for TRC (P=0.018; HR, 6.053; 95% CI, 1.364-26.869). Receiver operating characteristic curve analysis identified an optimal SRS cutoff of >1 for predicting TRC after anthracycline chemotherapy (P<0.001). Overall, the G-MPI SRS level was an early indicator for TRC surveillance in patients with DLBCL after anthracycline chemotherapy. The application of G-MPI SRS in clinical practice may contribute to early treatment and a subsequent decrease in mortality caused by such cardiovascular complications.

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          Most cited references53

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          ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.

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            Early detection of anthracycline cardiotoxicity and improvement with heart failure therapy.

            Three types of anthracycline-induced cardiotoxicities are currently recognized: acute, early-onset chronic, and late-onset chronic. However, data supporting this classification are lacking. We prospectively evaluated incidence, time of occurrence, clinical correlates, and response to heart failure therapy of cardiotoxicity.
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              Anthracycline Chemotherapy and Cardiotoxicity

              Anthracycline chemotherapy maintains a prominent role in treating many forms of cancer. Cardiotoxic side effects limit their dosing and improved cancer outcomes expose the cancer survivor to increased cardiovascular morbidity and mortality. The basic mechanisms of cardiotoxicity may involve direct pathways for reactive oxygen species generation and topoisomerase 2 as well as other indirect pathways. Cardioprotective treatments are few and those that have been examined include renin angiotensin system blockade, beta blockers, or the iron chelator dexrazoxane. New treatments exploiting the ErbB or other novel pro-survival pathways, such as conditioning, are on the cardioprotection horizon. Even in the forthcoming era of targeted cancer therapies, the substantial proportion of today’s anthracycline-treated cancer patients may become tomorrow’s cardiac patient.
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                Author and article information

                Journal
                Oncol Lett
                Oncol Lett
                OL
                Oncology Letters
                D.A. Spandidos
                1792-1074
                1792-1082
                December 2020
                06 October 2020
                06 October 2020
                : 20
                : 6
                : 330
                Affiliations
                [1 ]Department of Hematology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China
                [2 ]Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China
                [3 ]Department of Echocardiography, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China
                Author notes
                Correspondence to: Professor Weiying Gu, Department of Hematology, The Third Affiliated Hospital of Soochow University, 185 Juqian, Changzhou, Jiangsu 213003, P.R. China, E-mail: guweiying2017@ 123456126.com
                Professor Yuetao Wang, Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, 185 Juqian, Changzhou, Jiangsu 213003, P.R. China, E-mail: yuetao-w@ 123456163.com
                [*]

                Contributed equally

                Article
                OL-0-0-12194
                10.3892/ol.2020.12194
                7590429
                b5516d08-c208-4720-9d76-9c46779fedb3
                Copyright: © Lin et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 13 March 2020
                : 11 September 2020
                Categories
                Articles

                Oncology & Radiotherapy
                diffuse large b-cell lymphoma,summed rest score,gated myocardial perfusion imaging,treatment-related cardiotoxicity

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