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癌症患者中的应激性心肌病

Takotsubo cardiomyopathy in cancer patients.

作者信息

Desai Aakash, Noor Arish, Joshi Saurabh, Kim Agnes S

机构信息

Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.

2Department of Medicine, Division of Cardiology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-2202 USA.

出版信息

Cardiooncology. 2019 Jul 1;5:7. doi: 10.1186/s40959-019-0042-9. eCollection 2019.

Abstract

BACKGROUND

Cancer is a chronic condition that induces significant emotional and physical stress, which may increase the risk for developing Takotsubo cardiomyopathy (TCM).

MAIN BODY

Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a clinical syndrome that generally presents as chest pain mimicking acute coronary syndrome or as an acute heart failure characterized by severe left ventricular systolic dysfunction in response to emotional, physical, or medical stress. The potential triggers for Takotsubo syndrome in cancer patients include the emotional turmoil of a cancer diagnosis, the inflammatory state of the cancer itself, and the physical stress of cancer surgery, systemic anti-neoplastic therapy, and radiation treatment. TCM is becoming increasingly recognized among patients with cancer and has been associated with adverse outcomes in this patient population. In this study, we searched the Pubmed database using keywords "Takotsubo cardiomyopathy", "cancer", and "anti-neoplastic therapy" to review case reports of Takotsubo syndrome occurring in oncologic patients after systemic anti-neoplastic therapy. Clinical presentation, electrocardiogram, laboratory data, transthoracic echocardiogram and coronary angiogram results, and patient outcomes were collected and analyzed.

CONCLUSION

Patients with cancer are at an elevated risk for developing stress cardiomyopathy, and it is important to know which cancer drugs have been associated with the development of the Takotsubo syndrome.

摘要

背景

癌症是一种慢性疾病,会引发严重的情绪和身体压力,这可能会增加患应激性心肌病(TCM)的风险。

主体

应激性心肌病,也称为应激性心肌病,是一种临床综合征,通常表现为类似急性冠状动脉综合征的胸痛,或表现为因情绪、身体或医疗压力而导致严重左心室收缩功能障碍的急性心力衰竭。癌症患者发生应激性心肌病综合征的潜在触发因素包括癌症诊断带来的情绪波动、癌症本身的炎症状态以及癌症手术、全身抗肿瘤治疗和放射治疗带来的身体压力。应激性心肌病在癌症患者中越来越受到认可,并且与该患者群体的不良预后相关。在本研究中,我们使用关键词“应激性心肌病”、“癌症”和“抗肿瘤治疗”搜索了PubMed数据库,以回顾全身抗肿瘤治疗后肿瘤患者发生应激性心肌病综合征的病例报告。收集并分析了临床表现、心电图、实验室数据、经胸超声心动图和冠状动脉造影结果以及患者预后。

结论

癌症患者发生应激性心肌病的风险较高,了解哪些癌症药物与应激性心肌病综合征的发生有关很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84f3/7048040/3271f5af221b/40959_2019_42_Fig1_HTML.jpg

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