Marek J, Linhart A, Rucklová Z, Haber J, Korínek J
II. Interní klinika - klinika kardiologie a angiologie 1. lékarské fakulty UK a VFN Praha.
Vnitr Lek. 2011 May;57(5):472-84.
Due to advances in oncological care, the number of patients exposed to and surviving after anticancer chemotherapy is steadily increasing. Anticancer agents, however, are often associated with side-effects including cardiotoxicity which has been identified as one of the most serious and potentially life threatening complications. Cardiotoxicity manifestations range from asymptomatic alterations of heart and vasculature function to arterial hypertension, myocardial ischemia, arrhythmias (including QT-prolongation) and overt heart failure. Post-chemotherapy cardiovascular impairment has been associated with increased morbidity and may also contribute to increased mortality in these patients, both early and late after chemotherapy. This review article describes pathophysiology, clinical manifestation, diagnostic algorithms, monitoring and therapy of cardiotoxicity caused by anticancer agents. We also outline and discuss a variety of problems associated with patient management from the viewpoint of clinical cardiology according to latest published findings.
由于肿瘤治疗水平的提高,接受抗癌化疗并存活下来的患者数量正在稳步增加。然而,抗癌药物常常伴有副作用,包括心脏毒性,这已被确认为最严重且可能危及生命的并发症之一。心脏毒性的表现范围从心脏和血管功能的无症状改变到动脉高血压、心肌缺血、心律失常(包括QT间期延长)以及明显的心衰。化疗后心血管功能损害与发病率增加有关,也可能导致这些患者化疗后早期和晚期死亡率上升。这篇综述文章描述了抗癌药物所致心脏毒性的病理生理学、临床表现、诊断算法、监测及治疗。我们还根据最新发表的研究结果,从临床心脏病学的角度概述并讨论了与患者管理相关的各种问题。