cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2023.7.n2394cardio-2394Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESСердечно-сосудистые осложнения при иммунной противоопухолевой терапии ингибиторами контрольных точек: результаты 3‑месячного наблюденияImmune checkpoint inhibitors related cardiovascular toxicity: 3‑mounth follow-uphttps://orcid.org/0000-0002-8723-2765КушнареваЕ. А.KushnarevaE. A.

младший научный сотрудник,

Санкт-Петербург

junior researcher,

St. Petersburg

Kushnareva.cardio@gmail.comhttps://orcid.org/0000-0001-8084-3072ГаврилюкН. Д.GavrilukN. D.

научный сотрудник, к.м.н.,

Санкт-Петербург

researcher,

St. Petersburg

gavriliuk-ND@yandex.ruhttps://orcid.org/0000-0003-4428-8045ШугиноваТ. Н.ShuginovaT. N.

научный сотрудник,

Санкт-Петербург

researcher,

St. Petersburg

shuginova@mail.ruУрумоваЕ. Л.UrumovaE. L.

младший научный сотрудник,

Санкт-Петербург

junior researcher,

St. Petersburg

Urumova_EL@akmazovcentre.ruhttps://orcid.org/0000-0002-3655-9709КарелкинаЕ. В.KarelkinaE. V.

научный сотрудник,

Санкт-Петербург

researcher,

St. Petersburg

Karelkina_EV@akmazovcentre.ruhttps://orcid.org/0000-0001-9478-1941СимаковаМ. А.SimakovaM. A.

старший научный сотрудник, к.м.н.,

Санкт-Петербург

Senior Researcher,

St. Petersburg

maria.simakova@gmail.comhttps://orcid.org/0000-0003-2544-9042МоисеенкоФ. В.MoiseenkoF. V.

заведующий отделением химиотерапии №1, д.м.н.,

Санкт-Петербург

Head of the Department of Chemotherapy,

St. Petersburg

moiseenkofv@gmail.comhttps://orcid.org/0000-0002-7817-3847МоисееваО. М.MoiseevaO. M.

руководитель и главный научный сотрудник, д.м.н.,

Санкт-Петербург

Head of the department and leading researcher,

St. Petersburg

moiseeva.cardio@gmail.comФГБУ «Национальный медицинский исследовательский центр им. В. А. Алмазова» Минздрава России, Научный центр мирового уровня «Центр персонализированной медицины»РоссияAlmazov National Medical Research Center, World-Class Research Center for Personalized MedicineRussian FederationФГБУ «Национальный медицинский исследовательский центр имени В. А. Алмазова» Минздрава России, НИО некоронарогенных заболеваний сердцаРоссияAlmazov National Medical Research Center, Research Department for Non-Coronary Heart DiseaseRussian FederationФГБУ «Национальный медицинский исследовательский центр им. В. А. Алмазова» Минздрава России, Научный центр мирового уровня «Центр персонализированной медицины»; ГБУЗ «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический) им. Н. П. Напалкова»РоссияAlmazov National Medical Research Center, World-Class Research Center for Personalized Medicine; Napalkov Saint-Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncology)Russian FederationГБУЗ «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический) им. Н. П. Напалкова»РоссияNapalkov Saint-Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncology)Russian Federation2023280720236372331Copyright © Kardiomag, 20232023KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/2394Цель

Цель. Анализ состояния сердечно-сосудистой системы у онкологических пациентов, получающих иммунную противоопухолевую терапию ингибиторами контрольных точек (ИКТ) иммунного ответа, на основании лабораторных и инструментальных методов обследования по данным 3‑месячного наблюдения.

Материал и методы

Материал и методы. В многоцентровое проспективное наблюдательное исследование включены 49 пациентов (25 мужчин и 24 женщины, средний возраст 65,6±8,7 и 64,3±9,6 года соответственно). Всем пациентам выполнен лабораторный скрининг (С-реактивный белок, тропонин I, N-концевой фрагмент предшественника мозгового натрийуретического пептида), ЭхоКГ и УЗИ сонных артерий; 27 пациентов обследованы в динамике через 3 мес от начала противоопухолевой терапии. Статистический анализ выполнен с использованием программного обеспечения StatPlus 8.0.3.

Результаты

Результаты. Частота развития сердечно-сосудистых осложнений составила 16,3 %. Выявлены достоверные изменения ЭхоКГ-параметров: ФВ ЛЖ; (p=0,017), увеличение конечного систолического объе­ма (КСО) ЛЖ (р=0,023) и увеличение индекса производительности ЛЖ (LIMP; р=0,016). Установлена зависимость степени изменения КСО (ΔКСО) от наличия в анамнезе хроничес­кой сердечной недостаточности (р=0,03), а также степени изменения ФВ (ΔФВ) от возраста на момент начала противоопухолевой терапии (р=0,006). Выявлено увеличение степени максимального стеноза в бассейне общей сонной артерии по данным УЗИ (р=0,018).

Заключение

Заключение. Установлена высокая частота развития впервые возникших сердечно-сосудистых осложнений на фоне терапии ИКТ, а также наличие изменений ряда ЭхоКГ-параметров и данных УЗИ сонных артерий.

Aim

Aim. To analyze the condition of the cardiovascular system in oncological patients receiving immune antitumor therapy with immune checkpoint inhibitors (CPIs) based on results of laboratory and instrumental examinations during a 3-month follow-up.

Material and methods

Material and methods. This multicenter prospective observational study included 49 patients (25 men and 24 women aged 65.6±8.7 and 64.3±9.6 years, respectively). A laboratory screening (C-reactive proteins, troponin I, N-terminal pro-brain natriuretic peptide), EchoCG, and carotid ultrasound were performed for all patients. 27 patients were followed up at 3 months after the antitumor therapy initiation. Statistical analysis was performed with the StatPlus 8.0.3 software.

Results

Results. Incidence of cardiovascular complications was 16.3 %. The following significant changes in EchoCG parameters were observed: LV EF; (p=0.017), increased LV end-systolic volume (ESV) (р=0.023), and increased LV index of myocardial performance (LIMP; р=0.016). The degree of changes in ESV (ΔESV) depended on a history of chronic heart failure (р=0.03), whereas the degree of changes in EF (ΔEF) depended on the patient’s age at the initiation of antitumor therapy (р=0.006). Ultrasound showed an increase in maximum carotid stenosis (р=0.018).

Conclusion

Conclusion. The study showed a high incidence of newly developed cardiovascular complications associated with the CPI treatment as well as the presence of changes in EchoCG parameters and data of carotid ultrasound.

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The authors declare that there are no conflicts of interest present.