Poulin Frédéric, Thavendiranathan Paaladinesh
Division of Cardiology, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, ON, Canada, M5G 2C4.
Curr Cardiol Rep. 2015 Mar;17(3):564. doi: 10.1007/s11886-015-0564-1.
The identification of patients at risk of cardiac toxicity (cardiotoxicity) from cancer therapy is challenging. There is an increasing focus on early detection of cardiotoxicity such that interventions can be instituted to prevent advanced heart failure. Clinical risk prediction tools are limited and clinical symptoms are not specific. Direct assessment of myocardial function before and during cancer treatment using cardiac imaging appears to be an objective method to identify patients at risk. Although, multiple imaging modalities and measures of cardiac function are available, the best modality or the optimal measure of function is unknown. Measurement of left ventricular ejection fraction is most commonly used; however, growing literature suggests that it is inadequate for the detection of early cardiac injury. Other measures include left ventricular diastolic function, myocardial deformation, and myocardial tissue characterization. This review will provide an overview of the clinically available measures for the assessment of cardiotoxicity.
识别癌症治疗中存在心脏毒性风险的患者具有挑战性。目前越来越关注心脏毒性的早期检测，以便能够采取干预措施预防晚期心力衰竭。临床风险预测工具有限，且临床症状不具特异性。在癌症治疗前和治疗期间使用心脏成像直接评估心肌功能似乎是识别风险患者的一种客观方法。虽然有多种成像方式和心脏功能测量方法，但最佳方式或功能的最佳测量方法尚不清楚。左心室射血分数的测量最为常用；然而，越来越多的文献表明，它不足以检测早期心脏损伤。其他测量方法包括左心室舒张功能、心肌变形和心肌组织特征分析。本综述将概述临床上可用于评估心脏毒性的测量方法。
