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[如何组织癌症患者的心血管管理?]

[How to organise cardiovascular management of cancer patients?].

作者信息

Thuny Franck, Cautela Jennifer

机构信息

Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, unité Nord insuffisance cardiaque et valvulopathies, centre méditerranéen hospitalo-universitaire de cardiologie oncologique - Medi-CO Center, hôpital Nord, Marseille, France.

出版信息

Rev Prat. 2018 Mar;68(3):332-335.

Abstract

How to organise cardiovascular management of cancer patients? Advances in cancer therapy have reduced cancer mortality. However, these results are sometimes achieved at the cost of cardiovascular adverse events that may limit the overall benefit of treatment. Cardio-oncology is a recent discipline that aims to prevent, screen and manage cardiovascular diseases associated with or secondary to cancer treatment without compromising its effectiveness. These goals must therefore be integrated into the patient care program at the time of cancer diagnosis. Therefore, a cardiovascular toxicity risk assessment should be conducted prior treatment to identify patients candidate for closer monitoring. In parallel with their oncologic follow-up, these high-risk patients should receive cardiovascular follow-up that should not be restricted to a solely measurement of the left ventricular ejection fraction. Indeed, toxicities can be multiple, so the assessment must be comprehensive and should include at least clinical examination, ECG, cardiac imaging, and sometimes biomarkers. In the case of cardiovascular events, this organisation will enable an earlier and coordinated management with oncologists, which will result in an improvement of the patients' overall prognosis.

摘要

如何组织癌症患者的心血管管理?癌症治疗的进展降低了癌症死亡率。然而,这些成果有时是以心血管不良事件为代价取得的,而这些不良事件可能会限制治疗的总体益处。心脏肿瘤学是一门新兴学科,旨在预防、筛查和管理与癌症治疗相关或继发于癌症治疗的心血管疾病,同时不影响其疗效。因此,这些目标必须在癌症诊断时纳入患者护理计划。因此,应在治疗前进行心血管毒性风险评估,以确定需要密切监测的患者。在进行肿瘤学随访的同时,这些高危患者应接受心血管随访,且不应仅限于单纯测量左心室射血分数。事实上,毒性可能是多方面的,所以评估必须全面,至少应包括临床检查、心电图、心脏成像,有时还包括生物标志物。在发生心血管事件的情况下,这种组织方式将有助于与肿瘤学家进行更早且协调一致的管理,从而改善患者的总体预后。

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