Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305-5406, USA.
Semin Oncol. 2013 Apr;40(2):147-55. doi: 10.1053/j.seminoncol.2013.01.003.
Cardiovascular toxicity is one of the most feared complications of cancer treatment. Recent advances in oncologic therapies have resulted in improved cancer outcomes but also a new set of cardiovascular adverse effects. Common toxicities include left ventricular dysfunction/heart failure, hypertension, and myocardial ischemia. Accurate risk stratification allows avoidance of potentially harmful treatments in those patients at greatest risk while maintaining the ability to deliver high doses of effective therapies to the lower-risk population. Cardiac investigations, including echocardiography, nuclear imaging, magnetic resonance imaging, biomarker measurement, blood pressure monitoring, electrocardiography, stress testing, and invasive angiography, can help to risk-stratify selected patients. In this review, common complications are discussed in terms of the factors used to identify patients with elevated risk, the monitoring strategies available, and selected interventions that have been used to modify outcomes in patients identified as being at high risk for cardiac complications of cancer treatment.
心血管毒性是癌症治疗中最令人担忧的并发症之一。最近肿瘤治疗的进展改善了癌症的治疗效果，但也带来了一系列新的心血管不良事件。常见的毒性包括左心室功能障碍/心力衰竭、高血压和心肌缺血。准确的风险分层可以避免那些风险最高的患者接受潜在有害的治疗，同时保持对低风险人群给予高剂量有效治疗的能力。心脏检查，包括超声心动图、核成像、磁共振成像、生物标志物测量、血压监测、心电图、应激试验和有创血管造影，可以帮助对选定的患者进行风险分层。在这篇综述中，讨论了常见的并发症，并根据用于识别风险升高患者的因素、可用的监测策略以及用于改变被认为有癌症治疗相关心脏并发症高风险的患者结局的选定干预措施进行了讨论。
