癌症中的心脏萎缩与心力衰竭
Cardiac Atrophy and Heart Failure In Cancer.
作者信息
Sweeney Mark, Yiu Angela, Lyon Alexander R
机构信息
Cardio-Oncology Service, Royal Brompton Hospital, London, UK.
Faculty of Medicine, National Heart and Lung Institute, Imperial College London, UK.
出版信息
Card Fail Rev. 2017 Apr;3(1):62-65. doi: 10.15420/cfr.2017:3:2.
Functional changes in the heart in patients with cancer can be a result of both the disease itself and various cancer therapies, and limiting cardiac damage has become an increasingly important issue as survival rates in patients with cancer have improved. Processes involved in cancer-induced cardiac atrophy may include cardiomyocyte atrophy and apoptosis, decreased protein synthesis, increased autophagy and proteolysis via the ubiquitin-proteosome system. Further to direct effects of malignancy on the heart, several chemotherapeutic agents are known to affect the myocardium, in particular the anthracyclines. The aim of this report is to review the effects of cancer and cancer treatment on the heart and what is known about the underlying mechanisms. Furthermore, clinical strategies to limit and treat cancer-associated cardiac atrophy are discussed, emphasising the benefit of a multidisciplinary approach by cardiologists and oncologists to optimise models of care to improve outcomes for patients with cancer.
癌症患者心脏的功能变化可能是疾病本身以及各种癌症治疗的结果，随着癌症患者生存率的提高，限制心脏损伤已成为一个日益重要的问题。癌症诱发心脏萎缩所涉及的过程可能包括心肌细胞萎缩和凋亡、蛋白质合成减少、自噬增加以及通过泛素 - 蛋白酶体系统的蛋白水解。除了恶性肿瘤对心脏的直接影响外，已知几种化疗药物会影响心肌，尤其是蒽环类药物。本报告的目的是综述癌症及癌症治疗对心脏的影响以及对潜在机制的了解。此外，还讨论了限制和治疗癌症相关心脏萎缩的临床策略，强调心脏病专家和肿瘤学家采用多学科方法以优化护理模式从而改善癌症患者预后的益处。
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