Finet J Emanuel, Tang W H Wilson
Section of Heart Failure and Transplantation Medicine, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, and Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, USA.
Cleveland Clinic Lerner College of Medicine at Case Western Reserve University; Center for Clinical Genomics; Cleveland Clinic, Cleveland, USA.
F1000Res. 2018 Sep 28;7. doi: 10.12688/f1000research.15190.1. eCollection 2018.
Recent advances in cancer prevention and management have led to an exponential increase of cancer survivors worldwide. Regrettably, cardiovascular disease has risen in the aftermath as one of the most devastating consequences of cancer therapies. In this work, we define cancer therapeutics-induced cardiotoxicity as the direct or indirect cardiovascular injury or injurious effect caused by cancer therapies. We describe four progressive stages of this condition and four corresponding levels of prevention, each having a specific goal, focus, and means of action. We subsequently unfold this didactic framework, surveying mechanisms of cardiotoxicity, risk factors, cardioprotectants, biomarkers, and diagnostic imaging modalities. Finally, we outline the most current evidence-based recommendations in this area according to multidisciplinary expert consensus guidelines.
癌症预防和治疗方面的最新进展已导致全球癌症幸存者数量呈指数级增长。遗憾的是，随之而来的是心血管疾病的增加，这是癌症治疗最具破坏性的后果之一。在这项工作中，我们将癌症治疗引起的心脏毒性定义为癌症治疗导致的直接或间接心血管损伤或有害影响。我们描述了这种情况的四个进展阶段和相应的四级预防措施，每个阶段都有特定的目标、重点和行动方式。随后，我们展开这个教学框架，研究心脏毒性的机制、风险因素、心脏保护剂、生物标志物和诊断成像方式。最后，我们根据多学科专家共识指南概述该领域最新的循证建议。
