Department of Cardiology, Bern University Hospital, 3010 Bern, Switzerland.
Eur Heart J. 2013 Apr;34(15):1102-11. doi: 10.1093/eurheartj/ehs181. Epub 2012 Jul 12.
Progress in the detection and treatment of cancer has led to an impressive reduction in both mortality and morbidity. Due to their mechanism of action, however, conventional chemotherapeutics and some of the newer anti-cancer signaling inhibitors carry a substantial risk of cardiovascular side effects that include cardiac dysfunction and heart failure, arterial hypertension, vasospastic and thromboembolic ischaemia, dysrhythmia, and QT prolongation. While some of these side effects are irreversible and cause progressive cardiovascular disease, others induce only temporary dysfunction with no apparent long-term sequelae for the patient. The challenge for the cardiovascular specialist is to balance the need for life-saving cancer treatment with the assessment of risk from cancer drug-associated cardiovascular side effects to prevent long-term damage. This review discusses concepts for timely diagnosis, intervention, and surveillance of cancer patients undergoing treatment, and provides approaches to clinical uncertainties.
癌症的检测和治疗进展显著降低了死亡率和发病率。然而，由于其作用机制，传统的化疗药物和一些新型的抗癌信号抑制剂会带来严重的心血管副作用风险，包括心脏功能障碍和心力衰竭、动脉高血压、血管痉挛和血栓栓塞性缺血、心律失常以及 QT 间期延长。其中一些副作用是不可逆的，会导致进行性心血管疾病，而另一些副作用仅导致暂时的功能障碍，对患者没有明显的长期后果。心血管专家面临的挑战是在需要进行挽救生命的癌症治疗与评估癌症药物相关心血管副作用风险之间取得平衡，以防止长期损害。这篇综述讨论了对接受治疗的癌症患者进行及时诊断、干预和监测的概念，并提供了处理临床不确定性的方法。
