Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (J.M.S., D.G., L.W.H.).
Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway (T.S.N.).
Circulation. 2018 Mar 13;137(11):1176-1191. doi: 10.1161/CIRCULATIONAHA.117.024671.
Cardio-oncology is an emerging discipline focused predominantly on the detection and management of cancer treatment-induced cardiac dysfunction (cardiotoxicity), which predisposes to development of overt heart failure or coronary artery disease. The direct adverse consequences, as well as those secondary to anticancer therapeutics, extend beyond the heart, however, to affect the entire cardiovascular-skeletal muscle axis (ie, whole-organism cardiovascular toxicity). The global nature of impairment creates a strong rationale for treatment strategies that augment or preserve global cardiovascular reserve capacity. In noncancer clinical populations, exercise training is an established therapy to improve cardiovascular reserve capacity, leading to concomitant reductions in cardiovascular morbidity and its attendant symptoms. Here, we overview the tolerability and efficacy of exercise on cardiovascular toxicity in adult patients with cancer. We also propose a conceptual research framework to facilitate personalized risk assessment and the development of targeted exercise prescriptions to optimally prevent or manage cardiovascular toxicity after a cancer diagnosis.
心脏肿瘤学是一门新兴学科，主要专注于检测和管理癌症治疗引起的心脏功能障碍（心脏毒性），这会导致明显的心力衰竭或冠状动脉疾病的发生。然而，直接的不良后果以及抗癌治疗的间接后果不仅局限于心脏，还会影响整个心血管-骨骼肌轴（即全身心血管毒性）。损伤的全球性为增强或维持全身心血管储备能力的治疗策略提供了强有力的理由。在非癌症临床人群中，运动训练是一种已被证实的改善心血管储备能力的疗法，可同时降低心血管发病率及其相关症状。在这里，我们综述了运动对癌症成年患者心血管毒性的耐受性和疗效。我们还提出了一个概念性的研究框架，以促进个性化风险评估和制定有针对性的运动处方，以在癌症诊断后最佳地预防或管理心血管毒性。
