Knight Cardiovascular Institute, Division of Cardiology, Department of Medicine, Oregon Health & Science University, 3180 Sam Jackson Park Rd., Mail Code UHN62, Portland, OR, 97239, USA.
UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Curr Treat Options Oncol. 2019 May 6;20(6):47. doi: 10.1007/s11864-019-0645-2.
The increased risk for cardiovascular events in aging cancer survivors and those undergoing certain chemotherapeutic treatments has raised concern for more rigorous screening and surveillance methods above that of the general population. At this time, there are limited guidelines for how to best manage this vulnerable cohort. Questions regarding timing of screening, choice of imaging modality and risk reduction strategies-especially in those patients with known atherosclerotic disease-remain to be elucidated. Over a decade of case series, retrospective studies and clinical trials have shed light on the evolving role of cardiac computed tomography (CT) in this population, of which there is a relative paucity of data regarding its potential utility in the specific cardio-oncology population. Focusing on ability of cardiac CT to evaluate multiple cardiac and vascular structures, provide diagnostic and prognostic information, as well as assist interventional and surgical colleagues in surgical/percutaneous valve replacement and revascularization strategies is the premise for this review.
老龄化癌症幸存者和接受某些化疗治疗的患者发生心血管事件的风险增加,这引起了人们对更严格的筛查和监测方法的关注,这些方法超过了一般人群的标准。目前,关于如何最好地管理这一脆弱人群的指南有限。关于筛查的时间、影像学检查方式的选择和降低风险的策略的问题,尤其是在那些已知患有动脉粥样硬化疾病的患者中,仍然需要进一步阐明。十多年的病例系列、回顾性研究和临床试验揭示了心脏计算机断层扫描(CT)在这一人群中的作用不断演变,而关于其在心血管肿瘤学特定人群中的潜在用途的数据相对较少。本综述的前提是关注心脏 CT 评估多种心脏和血管结构的能力、提供诊断和预后信息,以及协助介入和外科医生在外科/经皮瓣膜置换和血运重建策略方面的应用。