Cardiology Unit, European Institute of Oncology, I.R.C.C.S, Milan, Italy.
Prog Cardiovasc Dis. 2010 Sep-Oct;53(2):121-9. doi: 10.1016/j.pcad.2010.04.002.
Chemotherapy-induced cardiotoxicity remains an unresolved problem strongly impacting the quality of life and the overall survival of cancer patients. The main strategy for minimizing cardiotoxicity is early detection of high-risk patients and prompt prophylactic treatment. The current standard for monitoring cardiac function detects cardiotoxicity only when a functional impairment has already occurred, not allowing for any early preventive strategies. Measurement of cardiospecific biomarkers can be a valid diagnostic tool for early identification, assessment, and monitoring of cardiotoxicity. In particular, the role of troponin in identifying patients at risk of cardiotoxicity and of angiotensin-converting enzyme inhibitors in preventing cardiac dysfunction and cardiac events is clearly emerging as a new effective approach. Therefore, we propose troponin as a criterion standard marker for the assessment of cardiac risk of both old and new antineoplastic treatments, and its evaluation should be included among the criteria utilized to define cardiotoxicity.
化疗引起的心脏毒性仍然是一个未解决的问题，严重影响癌症患者的生活质量和总体生存率。最大限度降低心脏毒性的主要策略是早期发现高危患者并及时进行预防性治疗。目前监测心脏功能的标准仅在已经发生功能损害时才检测到心脏毒性，不允许采取任何早期预防策略。心脏特异性生物标志物的测量可以作为早期识别、评估和监测心脏毒性的有效诊断工具。特别是，肌钙蛋白在识别有心脏毒性风险的患者，以及血管紧张素转换酶抑制剂预防心脏功能障碍和心脏事件方面的作用，显然已成为一种新的有效方法。因此，我们提出肌钙蛋白作为评估新旧抗肿瘤治疗心脏风险的标准标志物，其评估应包括在定义心脏毒性的标准中。
