From the Division of Cardiology and the Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Cardiol Rev. 2019 Sep/Oct;27(5):230-235. doi: 10.1097/CRD.0000000000000239.
Cardiotoxicity is a known complication of many cancer therapies. While the cardiotoxicity of established agents such as anthracyclines, antimetabolites, and alkylating agents is well known, it is important to realize that newer anticancer therapies such as tyrosine kinase inhibitors, angiogenesis inhibitors, and checkpoint inhibitors are also associated with significant adverse cardiovascular effects. Echocardiography, magnetic resonance imaging, and radionuclide imaging have been used to identify these complications early and prevent further consequences. We will discuss the different classes of cancer therapeutic agents that cause cardiotoxicity, the mechanisms that lead to these effects, and strategies that can be used to prevent the cardiac morbidity and mortality associated with their use.
心脏毒性是许多癌症治疗方法的已知并发症。虽然已有的药物如蒽环类药物、抗代谢药物和烷化剂的心脏毒性已广为人知,但需要认识到,新型的抗癌疗法,如酪氨酸激酶抑制剂、血管生成抑制剂和检查点抑制剂,也与显著的不良心血管效应相关。超声心动图、磁共振成像和放射性核素成像已被用于早期识别这些并发症,并防止进一步的后果。我们将讨论引起心脏毒性的不同类型的癌症治疗药物,导致这些影响的机制,以及可以用来预防与其使用相关的心脏发病率和死亡率的策略。