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[肿瘤心脏病学——从心脏病学角度看]

[Onco-Cardiology - From the Standpoint of Cardiology].

作者信息

Shioyama Wataru

机构信息

Dept. of Cardiovascular Medicine, Onco-Cardiology Unit, Osaka International Cancer Institute, Osaka Prefectural Hospital Organization.

出版信息

Gan To Kagaku Ryoho. 2017 Dec;44(13):2052-2057.

Abstract

In Japan, cardiovascular diseases are frequent complications in cancer patients owing to the rapidly aging population and changes in the overall lifestyle. In addition, new anticancer therapies have substantially improved the prognosis of cancer patients. Cardiotoxicity, also referred to as cancer treatment-related cardiac dysfunction, has become an important cause of morbidity and mortality in cancer patients. Cardiotoxicity may consist of hypertension, arrhythmia, thromboembolism, coronary artery disease, valvular disease, and left ventricular dysfunction which may progress to heart failure. Close interactions between cardiologists and oncologists are required for the optimal care of many cancer patients. Although cardiologists are expected to assist and advise the oncologist by providing diagnostic and prognostic information regarding developing cardiotoxicity, little is known about the cardiovascular pathogenic mechanisms associated with cancer treatment. Onco-cardiology is a medical subspecialty that focuses on the diagnosis and treatment of cardiotoxicity in cancer patients. This review describes the concept of onco-cardiology, and focuses on the management of cardiotoxicity that may arise during or after cancer therapy from the standpoint of cardiology. We also discuss noninvasive diagnostic options to identify and characterize cardiotoxicity.

摘要

在日本,由于人口迅速老龄化和整体生活方式的改变,心血管疾病是癌症患者常见的并发症。此外,新型抗癌疗法显著改善了癌症患者的预后。心脏毒性,也称为癌症治疗相关的心脏功能障碍,已成为癌症患者发病和死亡的重要原因。心脏毒性可能包括高血压、心律失常、血栓栓塞、冠状动脉疾病、瓣膜疾病以及可能进展为心力衰竭的左心室功能障碍。许多癌症患者的最佳治疗需要心脏病专家和肿瘤学家密切合作。虽然期望心脏病专家通过提供有关心脏毒性发生的诊断和预后信息来协助肿瘤学家并提供建议,但对于与癌症治疗相关的心血管致病机制知之甚少。肿瘤心脏病学是一个专注于诊断和治疗癌症患者心脏毒性的医学亚专业。本综述描述了肿瘤心脏病学的概念,并从心脏病学的角度重点关注癌症治疗期间或之后可能出现的心脏毒性的管理。我们还讨论了用于识别和表征心脏毒性的非侵入性诊断方法。

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