Mozos Ioana, Borzak Georgiana, Caraba Alexandru, Mihaescu Rodica
Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy.
Department of Hematology, "Oncohelp" Hospital.
Onco Targets Ther. 2017 Mar 3;10:1381-1388. doi: 10.2147/OTT.S126852. eCollection 2017.
Malignant and cardiovascular disorders are the top causes of mortality worldwide. This article reviews the main literature data and mechanisms linking hematologic malignancies and arterial stiffness, focusing on recent experimental and clinical results. Several links were found in hematologic malignancies between complete blood count and arterial stiffness. Chemotherapy, especially anthracyclines, cyclophosphamide and tyrosine kinase inhibitors, as well as radiotherapy and hematopoietic stem cell transplantation are the main known causes of arterial stiffness increase in hematologic malignancies. The mechanisms of arterial stiffness elevation in hematologic malignancies include an increased oxidative stress, impaired vascular wall homeostasis, endothelial dysfunction and apoptosis of endothelial cells, overexpression of inflammatory cytokines, accelerated atherosclerosis, increased blood viscosity and unstable platelet aggregates. Guidelines regarding cardiovascular health screening and cardiovascular risk scores are necessary for hematologic cancer survivors in order to improve prognosis and quality of life of the patients.
恶性肿瘤和心血管疾病是全球范围内的主要死因。本文回顾了将血液系统恶性肿瘤与动脉僵硬度联系起来的主要文献数据和机制,重点关注近期的实验和临床结果。在血液系统恶性肿瘤中,全血细胞计数与动脉僵硬度之间发现了几种联系。化疗,尤其是蒽环类药物、环磷酰胺和酪氨酸激酶抑制剂,以及放疗和造血干细胞移植是血液系统恶性肿瘤中已知的动脉僵硬度增加的主要原因。血液系统恶性肿瘤中动脉僵硬度升高的机制包括氧化应激增加、血管壁稳态受损、内皮功能障碍和内皮细胞凋亡、炎性细胞因子过度表达、动脉粥样硬化加速、血液粘度增加和血小板聚集不稳定。为了改善血液系统癌症幸存者的预后和生活质量,有必要制定关于心血管健康筛查和心血管风险评分的指南。