ORCID:0000-0002-0855-7079
Background
According to the 2018 Global
Cancer Statistics provided by the International Agency for Research on
Cancer, the number of new cancer cases were 18.1 million and 9.6 million
death cases global in 2018【1】. Colorectal cancer was
one of the most common malignant tumors in the world, accounting for
10% of all malignant tumors, which ranks the third in the malignant
tumors. In China, colorectal cancer was the fourth third leading cause
of cancer-associated mortality in men and the third in
women【2,3】. With the continuous progress and
maturity of radiotherapy and chemotherapy technology, the survival rate
of patients has improved through the application of anti-tumor drugs
alone or combined with radiotherapy. However, with the development of
chemotherapy, anthracycline was introduced into the field of tumor
therapy in 1960s, people have come to realize the cardiotoxicity caused
by chemotherapy for the first time. With the development of medical
technology, cardiotoxicity caused by anti-tumor drugs was gradually
familiar and valued by experts of various disciplines. It was recognized
that chemotherapy induced cardiotoxicity restrict the long-term survival
of patients to a certain extent, and increased the global public health
burden. In high-risk patients, prevention of heart failure caused by
chemotherapy was crucial to their long-term health. This would not only
increase their risk of cardiovascular disease and death, but also may
limit their ability to receive adequate cancer treatment. Therefore,
early detection of chemotherapy induced cardiotoxicity was very
important.
Cardiooncology was an emerging field that aimed to optimize cancer
treatment options and manage heart disease caused by cancer treatment.
In the past decade, cancer therapy has been greatly developed, including
many targeted therapies based on tumor genetics and receptor
characteristics【4】. However, these were accompanied
by a series of cardiovascular complications, including heart failure and
left ventricular systolic dysfunction, myocarditis, arrhythmia, coronary
artery, pericardial and valvular heart disease. More and more cardiac
imaging technology, accompanied by ever-increasing technological
developments, was applied to the diagnosis of diseases, such as speckle
tracking echocardiography, PET-CT cardiac magnetic resonance and so on.
But the best imaging method or biomarker to diagnose chemotherapy
induced cardiotoxicity was still controversial.
The 5-fluorouracil and bevacizumab were widely used in the treatment of
colorectal cancer【5】, but the early monitoring
method of the structure and function of heart injury caused by this
combination of the drugs was not perfect. This study used different
monitoring methods to compare the changes of cardiac structure and
function before and after the combination of bevacizumab and
5-fluorouracil injection in mice model. The purpose of this study was to
explore a safe and effective detection method with strong clinical
operability, which is in order to find an early detection of clinical
chemotherapy induced cardiotoxicity.