心脏毒性化疗用于治疗乳腺癌和淋巴瘤等恶性肿瘤。这些治疗使患者容易出现心脏毒性，从而导致癌症治疗相关的心功能障碍（CTRCD）。使用高剂量的蒽环类药物或与人表皮生长因子受体 2 拮抗剂联合使用会导致 CTRCD 风险逐渐升高。 CTRCD 之前会出现交感神经系统激活增加和通过异常整体纵向应变 (GLS) 测量的异常左心室机械变形。低水平耳屏刺激 (LLTS) 是一种新型、安全、无创技术，在减少交感神经激活和改善 GLS 方面具有巨大潜力。在这里，我们描述了一种研究方法，用于检查 LLTS 对接受蒽环类药物治疗的乳腺癌或淋巴瘤患者的自主平衡和心脏功能的影响。一项首次人体试点、随机、双盲可行性研究将评估 104 名患者（年龄> 50 岁）患有乳腺癌或淋巴瘤，接受蒽环类药物治疗并伴有一项额外的 CTRCD 风险因素。患者每天接受为期 2 周的 LLTS（1 小时/天）。自主平衡将使用心率变异性指标来测量。使用 GLS 的应变成像将在 LLTS 之前和之后进行。将在基线和两周后使用体外测定进行内皮炎症和氧化应激测量。我们假设 LLTS 可以稳定交感迷走失衡并改善接受蒽环类药物治疗的乳腺癌或淋巴瘤患者的心脏功能。版权所有 © 2024 Wolters Kluwer Health, Inc 。 版权所有。

Cardiotoxic chemotherapy is used to treat malignancies such as breast cancer and lymphoma. These treatments predispose patients to cardiotoxicity that can lead to cancer treatment-related cardiac dysfunction (CTRCD). The use of high doses of anthracyclines or in combination with human epidermal growth factor receptor 2 antagonists is associated with a progressively higher risk of CTRCD. CTRCD is preceded by increased activation of the sympathetic nervous system and abnormal left ventricular mechanical deformation as measured by abnormal global longitudinal strain (GLS). Low-level tragus stimulation (LLTS) is a new, safe, noninvasive technique that offers great potential to reduce increased sympathetic activation and improve GLS. Here, we describe a study method to examine the effects of LLTS on autonomic balance and cardiac function in breast cancer or lymphoma patients treated with anthracyclines.A first-in-human pilot, randomized, double-blind feasibility study will evaluate 104 patients (age >50 y) with breast cancer or lymphoma who receive anthracyclines with one additional CTRCD risk factor. Patients undergo 2 weeks of LLTS daily (1 h/d). Autonomic balance will be measured using heart rate variability metrics. Strain imaging using GLS will be performed pre and post-LLTS. Endothelial inflammation and oxidative stress measures will be performed using in vitro assays at baseline and after 2 weeks.We hypothesize that LLTS stabilizes sympathovagal imbalance and improves cardiac performance in anthracycline-treated patients with breast cancer or lymphoma.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.