O'Hare Meabh, Murphy Katie, Mookadam Farouk, Sharma Ashwini, Lee Howard
From the Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
Expert Rev Cardiovasc Ther. 2015 May;13(5):519-27. doi: 10.1586/14779072.2015.1027686. Epub 2015 Apr 12.
Cancer treatment has advanced in recent years with new drugs, complex regimes and multiple modalities of treatment; which has improved survival of cancer patients. Cardiotoxicity from chemotherapy is an emerging, important issue. Currently, echocardiographic evaluation of ejection fraction is the most commonly employed diagnostic tool for detecting chemotherapy-induced cardiotoxicity. However, novel echocardiographic techniques assessing myocardial mechanics using strain imaging can detect earlier changes. New imaging techniques and biomarkers can risk stratify patients to identify those requiring closer monitoring. Cardiologists collaborating with oncologists can detect and treat cardiovascular chemotherapeutic complications earlier, reducing morbidity and mortality. While cardiac MRI and multigated acquisition nuclear scanning are alternatives, echocardiography has become the mainstream for assessing cardiac function due to its portability, efficiency and low cost. Current recommendations regarding cardiac monitoring of cancer patients are based on expert consensus opinion. There is a need for prospective controlled trials to support specific guidelines.
近年来，随着新药、复杂治疗方案和多种治疗方式的出现，癌症治疗取得了进展，这提高了癌症患者的生存率。化疗引起的心脏毒性是一个新出现的重要问题。目前，射血分数的超声心动图评估是检测化疗引起的心脏毒性最常用的诊断工具。然而，使用应变成像评估心肌力学的新型超声心动图技术可以检测到更早的变化。新的成像技术和生物标志物可以对患者进行风险分层，以识别那些需要密切监测的患者。心脏病专家与肿瘤学家合作可以更早地检测和治疗心血管化疗并发症，降低发病率和死亡率。虽然心脏磁共振成像和多门控采集核扫描是替代方法，但由于其便携性、效率和低成本，超声心动图已成为评估心脏功能的主流方法。目前关于癌症患者心脏监测的建议基于专家共识意见。需要进行前瞻性对照试验来支持具体的指南。
