Echocardiography-Guided Radiofrequency Ablation for Cardiac Tumors

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI:10.1016/j.jaccao.2024.03.008

Junzhe Huang MS , Changhui Lei MBBS , David H. Hsi MD , Minjuan Zheng MD, PhD , Hui Ma MBBS , Shengjun Ta MBBS , Rui Hu MS , Chao Han MD, PhD , Wenxia Li MBBS , Jing Li MBBS , Dong Qu MBBS , Fangqi Ruan PhD , Jing Wang MD, PhD , Bo Wang MBBS , Xueli Zhao MBBS , Jiao Liu PhD , Lina Zhao MD, PhD , Zhe Wang MD, PhD , Jian Yang MD, PhD , Liwen Liu MD, PhD

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Abstract

Background

Patients with cardiac tumors may present challenges for surgical resection due to poor clinical condition. Echocardiography-guided transapical radiofrequency ablation for cardiac tumors (TARFACT) potentially offers a less invasive palliative therapy option.

Objectives

This study aimed to evaluate the safety and efficacy of TARFACT.

Methods

Five patients with cardiac tumors (mucinous liposarcoma, myocardial hypertrophy with inflammatory cell infiltration mass, fibrous tissue tumor hyperplasia, myocardial clear cell sarcoma, and cardiac rhabdomyoma) were included. All patients underwent TARFACT and were assessed with electrocardiogram, echocardiographic imaging, biochemical analysis, and pathological confirmation.

Results

The median follow-up for all patients was 9 (range 4-12) months. Three surviving patients were alive at their last follow-up (9, 12, and 12 months, respectively), whereas 2 patients with late-stage tumors survived 6 months and 13 months after TARFACT, respectively. After TARFACT, all patients showed significant reductions in tumor size: the mean length decreased from 6.7 ± 2.0 cm to 4.7 ± 1.8 cm (P = 0.007); and the mean width decreased from 5.0 ± 2.1 cm to 2.5 ± 0.7 cm (P = 0.041). NYHA functional class also improved: median (IQR) decreased from 3.0 (1.5) to 2.0 (1.0) (P = 0.038), Peak E-wave on echocardiography showed a mean increase from 64.4 ± 15.7 cm/s to 76.6 ± 18.6 cm/s (P = 0.008), and NT-pro BNP levels had a median (IQR) reduction from 115.7 (252.1) pg/mL to 55.0 (121.6) pg/mL (P = 0.043).

Conclusions

TARFACT is a novel palliative treatment option for cardiac tumors, reducing accessible tumors and improving clinical symptoms in a preliminary group of patients. (Cardiac Tumors Interventional [Radio Frequency/Laser Ablation] Therapy [CTIH]; NCT02815553)

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超声心动图引导下的心脏肿瘤射频消融术

背景心脏肿瘤患者由于临床状况不佳，手术切除可能面临挑战。本研究旨在评估 TARFACT 的安全性和有效性。方法纳入五例心脏肿瘤患者（粘液性脂肪肉瘤、心肌肥大伴炎性细胞浸润肿块、纤维组织瘤增生、心肌透明细胞肉瘤和心脏横纹肌瘤）。结果所有患者的中位随访时间为 9 个月（4-12 个月）。三名存活患者在最后一次随访时（分别为 9 个月、12 个月和 12 个月）仍然存活，两名晚期肿瘤患者分别在 TARFACT 术后 6 个月和 13 个月存活。TARFACT 术后，所有患者的肿瘤大小均显著缩小：平均长度从 6.7 ± 2.0 厘米降至 4.7 ± 1.8 厘米（P = 0.007）；平均宽度从 5.0 ± 2.1 厘米降至 2.5 ± 0.7 厘米（P = 0.041）。NYHA 功能分级也有所改善：中位数（IQR）从 3.0 (1.5) 降至 2.0 (1.0) (P = 0.038)，超声心动图显示的峰值 E 波平均速度从 64.4 ± 15.7 cm/s 升至 76.6 ± 18.6 cm/s (P = 0.008)，NT-pro BNP 水平的中位数（IQR）从 115.结论TARFACT是一种新型的心脏肿瘤姑息治疗方案，可减少可触及的肿瘤，并初步改善一组患者的临床症状。(心脏肿瘤介入[射频/激光消融]疗法[CTIH]；NCT02815553）

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来源期刊

Jacc: Cardiooncology Multiple-

CiteScore

12.50

自引率

6.30%

发文量

106

期刊介绍： JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge. The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention. Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.