Rose-Felker Kirsten, Border William L, Hong Borah J, Chow Eric J
Department of Pediatrics, Sibley Heart Center Cardiology, 201 Dowman Drive, Atlanta, GA 30322, USA; Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA.
Department of Pediatrics, Sibley Heart Center Cardiology, 201 Dowman Drive, Atlanta, GA 30322, USA; Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA.
Heart Fail Clin. 2017 Apr;13(2):311-325. doi: 10.1016/j.hfc.2016.12.007.
Although tremendous advances in pediatric cancer treatment have improved the survival of many children, these patients remain at increased risk of early morbidity and mortality with cardiovascular disease as a leading cause of death. Heightened awareness in providers with increased surveillance and improvement in cardiovascular imaging modalities have led to earlier detection of cardiac dysfunction, but the outcomes remain poor once this has dysfunction developed. A great deal of work remains to be done to refine screening and identify high-risk patients more precisely, and to develop more evidence-based strategies for effective primary and secondary cardioprotection and treatment.
尽管儿科癌症治疗取得了巨大进展,提高了许多儿童的生存率,但这些患者仍面临早期发病和死亡风险增加的问题,心血管疾病是主要死因。医疗人员的意识提高、监测增加以及心血管成像方式的改进,已使心脏功能障碍得以更早发现,但一旦出现功能障碍,预后仍然很差。在优化筛查、更精确地识别高危患者以及制定更具循证性的有效一级和二级心脏保护及治疗策略方面,仍有大量工作要做。