Jain Diwakar, Ahmad Tauseef, Cairo Mitchel, Aronow Wilbert
Section of Cardiovascular Medicine, Department of Pediatrics, New York Medical College and Westchester Medical Center, Valhalla, NY, USA.
Section of Oncology and Hematology, Department of Pediatrics, New York Medical College and Westchester Medical Center, Valhalla, NY, USA.
Ann Transl Med. 2017 Sep;5(17):348. doi: 10.21037/atm.2017.06.35.
Cardiotoxicity is an important complication of several cancer therapeutic agents. Several well established and newer anticancer therapies such as anthracyclines, trastuzumab and other HER2 receptor blockers, antimetabolites, alkylating agents, tyrosine kinase inhibitors (TKIs), angiogenesis inhibitors, and checkpoint inhibitors are associated with significant cardiotoxicity. Cardiovascular imaging employing radionuclide imaging, echocardiography and magnetic resonance imaging are helpful in early detection and prevention of overt heart failure secondary to cardiotoxicity of cancer therapy. An understanding of the mechanism of the cardiotoxicity of cancer therapies can help prevent and treat their adverse cardiovascular consequences. Clinical implementation of algorithms based upon cardiac imaging and several non-imaging biomarkers can prevent cardiac morbidity and mortality associated with the use of cardiotoxic cancer therapies.
心脏毒性是几种癌症治疗药物的重要并发症。几种已确立的和新型的抗癌疗法，如蒽环类药物、曲妥珠单抗和其他HER2受体阻滞剂、抗代谢物、烷化剂、酪氨酸激酶抑制剂（TKIs）、血管生成抑制剂和检查点抑制剂，都与显著的心脏毒性有关。采用放射性核素成像、超声心动图和磁共振成像的心血管成像有助于早期检测和预防癌症治疗心脏毒性继发的明显心力衰竭。了解癌症治疗心脏毒性的机制有助于预防和治疗其不良心血管后果。基于心脏成像和几种非成像生物标志物的算法的临床应用可以预防与使用具有心脏毒性的癌症治疗相关的心脏发病率和死亡率。
