Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, Missouri.
Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida.
J Am Coll Cardiol. 2020 Nov 10;76(19):2267-2281. doi: 10.1016/j.jacc.2020.08.079.
The innovative development of cancer therapies has led to an unprecedented improvement in survival outcomes and a wide array of treatment-related toxicities, including those that are cardiovascular in nature. Aging of the population further adds to the number of patients being treated for cancer, especially those with comorbidities. Such pre-existing and developing cardiovascular diseases pose some of the greatest risks of morbidity and mortality in patients with cancer. Addressing the complex cardiovascular needs of these patients has become increasingly important, resulting in an imperative for an intersecting discipline: cardio-oncology. Over the past decade, there has been a remarkable rise of cardio-oncology clinics and service lines. This development, however, has occurred in a vacuum of standard practice and training guidelines, although these are being actively pursued. In this council perspective document, the authors delineate the scope of practice in cardio-oncology and the proposed training requirements, as well as the necessary core competencies. This document also serves as a roadmap toward confirming cardio-oncology as a subspecialty in medicine.
癌症治疗的创新发展带来了生存结果的空前改善,以及广泛的治疗相关毒性,包括那些本质上是心血管的毒性。人口老龄化进一步增加了癌症治疗患者的数量,尤其是那些患有合并症的患者。这些预先存在和发展的心血管疾病给癌症患者带来了最大的发病率和死亡率风险。满足这些患者复杂的心血管需求变得越来越重要,因此交叉学科——肿瘤心脏病学应运而生。在过去的十年中,肿瘤心脏病学诊所和服务线的数量显著增加。然而,这种发展是在缺乏标准实践和培训指南的情况下发生的,尽管这些指南正在积极制定中。在本理事会观点文件中,作者阐述了肿瘤心脏病学的实践范围和拟议的培训要求,以及必要的核心能力。本文档还为将肿瘤心脏病学确认为医学的一个亚专科提供了路线图。