Cardio-Oncology Program, Division of Cardiovascular Medicine, University of South Florida Morsani College of Medicine and H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr., MCB-CPT, Tampa, FL, 33612-9416, USA.
Curr Treat Options Oncol. 2019 May 25;20(7):55. doi: 10.1007/s11864-019-0657-y.
Cardiovascular toxicities are potentially serious treatment limiting complications of many different cancer therapeutics including traditional cytotoxic chemotherapies as well as targeted- and immunotherapies. As a result, there is increased monitoring for cancer treatment-related cardiotoxicities, ranging from heart failure to arrhythmias. Many anticancer treatments are known to prolong the QT interval through a variety of mechanisms including direct effects on ion channels and indirectly via intracellular signaling pathways. While QT prolongation increases the risk for the potentially life-threatening ventricular arrhythmia torsades de pointes, the incidence of this arrhythmia in the setting of most cancer treatments is quite rare, and the majority of patients can continue safely receiving these medications despite their QT prolonging potential. A multidisciplinary approach to the cardiovascular care of the cancer patient is essential to mitigate risk of cardiotoxicity while minimizing unnecessary treatment disruption of potentially life-saving cancer treatments.
心血管毒性是许多不同癌症治疗方法（包括传统细胞毒性化疗药物以及靶向治疗和免疫治疗）潜在的严重治疗限制并发症。因此，对癌症治疗相关的心血管毒性进行了更多的监测，包括心力衰竭到心律失常。许多抗癌治疗方法已知通过多种机制延长 QT 间期，包括直接作用于离子通道和间接通过细胞内信号通路。虽然 QT 间期延长会增加潜在威胁生命的室性心律失常尖端扭转型室性心动过速的风险，但大多数癌症治疗中这种心律失常的发生率相当罕见，大多数患者可以继续安全地接受这些药物，尽管它们有延长 QT 间期的潜在风险。对癌症患者的心血管护理采取多学科方法至关重要，可在最大程度降低心血管毒性风险的同时，尽量减少对潜在救命癌症治疗的不必要治疗中断。
