The aim of this study is to evaluate changes in epicardial adipose tissue (EAT) and cardiac extracellular volume (ECV) in patients with follicular lymphoma (FL) treated with R-CHOP-like regimens or R-bendamustine. We included 80 patients with FL between the ages of 60 and 80 and, using computed tomography (CT) performed at onset and at the end of treatment, we assessed changes in EAT by measuring tissue density at the level of the cardiac apex, anterior interventricular sulcus and posterior interventricular sulcus of the heart. EAT is known to be associated with metabolic syndrome, increased calcium in the coronary arteries and therefore increased risk of coronary artery disease. We also evaluated changes in ECV, which can be used as an early imaging marker of cardiac fibrosis and thus myocardial damage. The R-CHOP-like regimen was associated with lower EAT values (p< 0.001), indicative of a less active metabolism and more adipose tissue, and an increase in ECV (p< 0.001). Furthermore, in patients treated with anthracyclines and steroids (R-CHOP-like) there is a greater decrease in ejection fraction (EFp< 0.001) than in the R-B group. EAT and ECV may represent early biomarkers of cardiological damage, and this may be considered, to our knowledge, the first study investigating radiological and cardiological parameters in patients with FL.
本研究旨在评估接受R-CHOP样方案或R-苯达莫司汀治疗的滤泡性淋巴瘤（FL）患者心外膜脂肪组织（EAT）与心脏细胞外容积（ECV）的变化。我们纳入了80例年龄在60至80岁之间的FL患者，通过对比治疗起始与结束时进行的计算机断层扫描（CT），测量心脏心尖部、前室间沟和后室间沟水平的组织密度以评估EAT变化。已知EAT与代谢综合征、冠状动脉钙化增加相关，进而增加冠状动脉疾病风险。同时我们评估了ECV的变化，该指标可作为心脏纤维化及心肌损伤的早期影像学标志物。研究发现，R-CHOP样方案与较低的EAT值相关（p<0.001），提示代谢活性降低及脂肪组织增多，同时伴随ECV升高（p<0.001）。此外，接受蒽环类药物及类固醇治疗（R-CHOP样方案）的患者较R-B组患者出现更显著的射血分数下降（EFp<0.001）。EAT与ECV可能成为心脏损伤的早期生物标志物，据我们所知，本研究是首个针对FL患者放射学与心脏学参数的探索性研究。
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