Kongbundansuk Suwat, Hundley W Gregory
Department of Internal Medicine (Section on Cardiology), Wake Forest School of Medicine, Winston-Salem, North Carolina.
Department of Internal Medicine (Section on Cardiology), Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
JACC Cardiovasc Imaging. 2014 Aug;7(8):824-38. doi: 10.1016/j.jcmg.2014.06.007.
The introduction of multiple treatments for cancer, including chemotherapeutic agents and radiation therapy, has significantly reduced cancer-related morbidity and mortality. However, these therapies can promote a variety of toxicities, among the most severe being the ones involving the cardiovascular system. Currently, for many surviving cancer patients, cardiovascular (CV) events represent the primary cause of morbidity and mortality. Recent data suggest that CV injury occurs early during cancer treatment, creating a substrate for subsequent cardiovascular events. Researchers have investigated the utility of noninvasive imaging strategies to detect the presence of CV injury during and after completion of cancer treatment because it starts early during cancer therapy, often preceding the development of chemotherapy or cancer therapeutics related cardiac dysfunction. In this State-of-the-Art Paper, we review the utility of current clinical and investigative CV noninvasive modalities for the identification and characterization of cancer treatment-related CV toxicity.
多种癌症治疗方法的引入,包括化疗药物和放射治疗,显著降低了癌症相关的发病率和死亡率。然而,这些疗法会引发多种毒性反应,其中最严重的是涉及心血管系统的毒性反应。目前,对于许多癌症幸存者来说,心血管事件是发病和死亡的主要原因。最新数据表明,心血管损伤在癌症治疗早期就会发生,为后续心血管事件埋下隐患。研究人员已经对非侵入性成像策略在癌症治疗期间及结束后检测心血管损伤的效用进行了研究,因为这种损伤在癌症治疗早期就开始出现,通常先于化疗或癌症治疗相关心脏功能障碍的发生。在这篇前沿论文中,我们回顾了当前临床和研究中用于识别和表征癌症治疗相关心血管毒性的非侵入性心血管检查方法的效用。