Cardio-Oncology Service, Royal Brompton Hospital, Sydney St, Chelsea, London, SW3 6NP, UK.
National Heart and Lung Institute, Imperial College London, London, UK.
J Cardiovasc Transl Res. 2020 Jun;13(3):431-450. doi: 10.1007/s12265-020-10042-3. Epub 2020 Jul 8.
In the field of cardio-oncology, it is well recognised that despite the benefits of chemotherapy in treating and possibly curing cancer, it can cause catastrophic damage to bystander tissues resulting in a range of potentially of life-threatening cardiovascular toxicities, and leading to a number of damaging side effects including heart failure and myocardial infarction. Cardiotoxicity is responsible for significant morbidity and mortality in the long-term in oncology patients, specifically due to left ventricular dysfunction. There is increasing emphasis on the early use of biomarkers in order to detect the cardiotoxicity at a stage before it becomes irreversible. The most important markers of cardiac injury are cardiac troponin and natriuretic peptides, whilst markers of inflammation such as interleukin-6, C-reactive protein, myeloperoxidase, Galectin-3, growth differentiation factor-15 are under investigation for their use in detecting cardiotoxicity early. In addition, microRNAs, genome-wide association studies and proteomics are being studied as novel markers of cardiovascular injury or inflammation. The aim of this literature review is to discuss the evidence base behind the use of these biomarkers for the detection of cardiotoxicity.
在心血管肿瘤学领域,人们已经充分认识到,尽管化疗在治疗和可能治愈癌症方面具有益处,但它也可能对旁观者组织造成灾难性的损害,导致一系列潜在的危及生命的心血管毒性,并导致许多破坏性的副作用,包括心力衰竭和心肌梗死。心脏毒性是肿瘤患者长期发生重大发病率和死亡率的原因,具体原因是左心室功能障碍。人们越来越强调早期使用生物标志物,以便在心脏毒性变得不可逆转之前检测到它。心脏损伤最重要的标志物是心肌肌钙蛋白和利钠肽,而白细胞介素-6、C 反应蛋白、髓过氧化物酶、半乳糖凝集素-3、生长分化因子-15 等炎症标志物也正在研究中,以期早期检测心脏毒性。此外,microRNAs、全基因组关联研究和蛋白质组学也被作为心血管损伤或炎症的新型标志物进行研究。本文综述的目的是讨论这些生物标志物用于检测心脏毒性的证据基础。