CT显示的心肌细胞外体积可预测前列腺癌患者的主要不良心血管事件

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-08-18 DOI:10.1016/j.ejrad.2025.112371

Xinyu Zhang , Hesong Shen , Qian Xu , Chunrong Tu , Yangling Peng , Tao Liu , Xun Qiu , Jiuquan Zhang

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引用次数: 0

摘要

背景：前列腺癌（PCa）患者接受雄激素剥夺治疗（ADT）的心脏毒性和主要不良心血管事件（MACE）的风险很高。目前尚不清楚胸部增强CT （CECT）获得的心肌细胞外体积（ECV）是否可以检测心脏毒性并预测这些患者的MACE。本研究旨在评估在接受ADT的PCa患者中，胸部CECT衍生的心肌ECV在检测心脏毒性方面的价值，以及ECV与MACE的关系。方法回顾性分析2014年12月1日至2020年3月31日期间发生ADT的spca患者。在ADT开始前和ADT开始后约3、6、9和12个月获得胸部CECT衍生的心肌ECV。采用Student 's t检验分析MACE（+）组和MACE（-）组心肌ECV的差异，采用Cox比例风险模型分析心肌ECV与MACE的相关性。结果共纳入180例患者，其中44例发生MACE。心肌ECV在ADT治疗3个月后显著高于基线，并在ADT治疗12个月后达到峰值。每次随访时，MACE（+）组心肌ECV均高于MACE（-）组。ADT后3、6和9个月较高的ECV与MACE风险增加相关（调整后的风险比分别为2.695、3.670和4.450）。结论胸部CECT心肌ECV可用于动态监测前列腺癌ADT患者的心脏毒性和预测MACE。

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CT derived myocardial extracellular volume predict major adverse cardiovascular events in patients with prostate cancer

Background

Prostate cancer (PCa) patients with androgen deprivation therapy (ADT) are at high risk for cardiotoxicity and major adverse cardiovascular events (MACE). It is unclear whether the myocardial extracellular volume (ECV) derived from chest contrast-enhanced CT (CECT) can detect cardiotoxicity and predict MACE in these patients. This work aimed to assess the value of chest CECT derived myocardial ECV for detecting cardiotoxicity and the association of ECV with MACE in PCa patients receiving ADT.

Methods

PCa patients with ADT between December 1, 2014 and March 31, 2020 were retrospectively included. Chest CECT derived myocardial ECV was obtained before ADT and approximately 3, 6, 9, and 12 months after ADT initiation. The differences in myocardial ECV between the MACE (+) and MACE (−) groups were analyzed by Student’s t-test, and the association between myocardial ECV and MACE was analyzed using a Cox proportional hazards model.

Results

In total, 180 patients were included, of whom 44 patients developed MACE. Myocardial ECV was significantly higher after 3 months of ADT than at baseline and peaked after 12 months of ADT. Moreover, the myocardial ECV of the MACE (+) group was higher than that of the MACE (−) group at each follow-up visit. A higher ECV at 3, 6, and 9 months after ADT was associated with an increased risk for MACE (adjusted hazard ratios were 2.695, 3.670, and 4.450, respectively).

Conclusion

Myocardial ECV derived from chest CECT can be used to dynamically monitor cardiotoxicity and predict MACE in patients with PCa receiving ADT.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.