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癌症治疗的心血管并发症:诊断、发病机制与管理

Cardiovascular complications of cancer therapy: diagnosis, pathogenesis, and management.

作者信息

Yeh Edward T H, Tong Ann T, Lenihan Daniel J, Yusuf S Wamique, Swafford Joseph, Champion Christopher, Durand Jean-Bernard, Gibbs Harry, Zafarmand Alireza Atef, Ewer Michael S

机构信息

Department of Cardiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Tex 77030-4095, USA.

出版信息

Circulation. 2004 Jun 29;109(25):3122-31. doi: 10.1161/01.CIR.0000133187.74800.B9.

Abstract

The cardiotoxicity of anticancer agents can lead to significant complications that can affect patients being treated for various malignancies. The severity of such toxicity depends on many factors such as the molecular site of action, the immediate and cumulative dose, the method of administration, the presence of any underlying cardiac condition, and the demographics of the patient. Moreover, toxicity can be affected by current or previous treatment with other antineoplastic agents. Cardiotoxic effects can occur immediately during administration of the drug, or they may not manifest themselves until months or years after the patient has been treated. In this article we review commonly used chemotherapy agents, including several recently approved medications, for their propensity to cause cardiotoxicity. Further research will be required to more accurately predict which patients are at risk for developing cardiotoxicity. In addition, management plans, as well as strategies to reduce cardiotoxicity, need to be developed.

摘要

抗癌药物的心脏毒性可导致严重并发症,影响接受各种恶性肿瘤治疗的患者。此类毒性的严重程度取决于许多因素,如分子作用位点、即刻剂量和累积剂量、给药方法、是否存在任何潜在心脏疾病以及患者的人口统计学特征。此外,毒性可能会受到当前或既往使用其他抗肿瘤药物治疗的影响。心脏毒性作用可在给药期间立即出现,也可能在患者接受治疗数月或数年之后才显现出来。在本文中,我们综述了常用的化疗药物,包括几种最近获批的药物,以了解它们导致心脏毒性的倾向。需要进一步研究以更准确地预测哪些患者有发生心脏毒性的风险。此外,还需要制定管理计划以及降低心脏毒性的策略。

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