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蒽环类抗生素所致心脏毒性的病理生理学和预防策略的最新进展。

Update on pathophysiology and preventive strategies of anthracycline-induced cardiotoxicity.

机构信息

Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium.

Department of Surgery and Physiology, UnIC-Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

Clin Exp Pharmacol Physiol. 2019 Mar;46(3):204-215. doi: 10.1111/1440-1681.13036. Epub 2018 Oct 30.

Abstract

Anthracycline chemotherapy has a prominent role in treating many forms of cancer. Unfortunately, cardiotoxic side effects represent a serious limitation to their use, with doxorubicin being the leading drug of the group. Indeed, anthracycline-induced cardiomyopathy is an important public health concern because it may not be detected for many years and remains a lifelong threat. Even after decades of investigation, neither the exact mode of action of anthracyclines nor the pathways leading to their side effect are fully understood. It is increasingly important to establish collaboration between oncologists and cardiologists to improve the management of cancer patient receiving anthracyclines. This article reviews the clinical course, pathogenesis, cardiac monitoring and new concepts in diagnosing and preventing anthracycline-induced cardiotoxicity.

摘要

蒽环类化疗在治疗多种癌症中起着重要作用。不幸的是,心脏毒性副作用是其使用的一个严重限制,多柔比星是该类药物中的主要药物。事实上,蒽环类药物诱导的心肌病是一个重要的公共卫生问题,因为它可能在多年后才被发现,并且仍然是终身威胁。即使经过几十年的研究,蒽环类药物的确切作用机制以及导致其副作用的途径仍未完全了解。肿瘤学家和心脏病学家之间建立合作关系以改善接受蒽环类药物治疗的癌症患者的管理变得越来越重要。本文综述了蒽环类药物诱导的心脏毒性的临床过程、发病机制、心脏监测以及在诊断和预防方面的新概念。

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