Anakwue Raphael
Department of Medicine; Department of Pharmacology and Therapeutics, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria.
Ann Afr Med. 2020 Jan-Mar;19(1):1-7. doi: 10.4103/aam.aam_24_19.
We report three cases of heart failure (HF) associated with the use of cytotoxic drugs such as anthracycline, cyclophosphamide, and 5-fluorouracil in the treatment of breast cancer in Nigerians. The patients had systolic and diastolic HF: HF with reduced ejection fraction and preserved ejection fraction. The prevalence of breast cancer is increasing across Africa, and cytotoxics are some of the most common and best drugs used during management. The cardiotoxicity caused by these drugs limits their use as chemotherapeutic agents. Cytotoxic-induced HF is a preventable and manageable cause of cardiovascular disease (CVD) in Nigeria and Africa. This article discusses the pathophysiology of cytotoxic-induced HF and presents the risk factors that impair cardiovascular function. The importance of proper assessment and the prophylactic and therapeutic measures in the management of cytotoxic-induced HF are emphasized. The peculiar challenges in the management of cytotoxic-induced HF in Nigeria were also discussed. The need for early involvement of cardiologists by oncologists to improve on the chemotherapeutic and cardiovascular outcome in the management of patients with breast cancer was stressed. Perhaps, it is time to birth a new discipline of cardiooncology in Nigeria.
我们报告了三例在尼日利亚乳腺癌治疗中使用细胞毒性药物（如蒽环类、环磷酰胺和5-氟尿嘧啶）引发心力衰竭（HF）的病例。这些患者出现了收缩性和舒张性心力衰竭，即射血分数降低的心力衰竭和射血分数保留的心力衰竭。非洲各地乳腺癌的患病率正在上升，细胞毒性药物是治疗过程中最常用且效果较好的药物之一。这些药物引起的心脏毒性限制了它们作为化疗药物的使用。在尼日利亚和非洲，细胞毒性药物诱发的心力衰竭是心血管疾病（CVD）中一种可预防和可管理的病因。本文讨论了细胞毒性药物诱发心力衰竭的病理生理学，并介绍了损害心血管功能的危险因素。强调了在细胞毒性药物诱发心力衰竭的管理中进行适当评估以及采取预防和治疗措施的重要性。还讨论了尼日利亚在细胞毒性药物诱发心力衰竭管理中面临的特殊挑战。强调肿瘤学家应尽早让心脏病专家参与，以改善乳腺癌患者治疗中的化疗和心血管治疗效果。也许，现在是在尼日利亚开创心脏肿瘤学这一新学科的时候了。
