Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital Paolo Giaccone, Palermo, University of Palermo, Palermo, Italy.
Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.
J Am Soc Echocardiogr. 2021 Feb;34(2):107-116. doi: 10.1016/j.echo.2020.10.002. Epub 2020 Nov 19.
In recent years, the survival of patients with cancer has improved thanks to advances in antineoplastic therapeutic protocols. This has led to an increasing burden of cardiovascular complications related to cancer treatment. Therefore, a new branch of cardiology has been created, "cardio-oncology," with the aims of preventing cardiovascular complications related to antineoplastic treatment, achieving early diagnosis and treatment of any complications, and allowing completion of the expected antineoplastic treatment. Stress echocardiography has a pivotal role in achieving a timely diagnosis of coronary artery disease and thus is the best management approach in this clinical setting. Atherosclerotic processes can be exacerbated by both chemotherapy and chest irradiation in patients with cancer, even several years after anticancer treatment completion. Moreover, stress echocardiography has many other potential applications, such as in the evaluation of subclinical left ventricular dysfunction and contractile reserve in patients treated with anticancer drugs that have the potential to induce myocardial damage, as well as evaluating valve disease. The objective of this review is to delineate the role of stress echocardiography in cardio-oncology.
近年来,由于抗肿瘤治疗方案的进步,癌症患者的生存率有所提高。这导致与癌症治疗相关的心血管并发症负担不断增加。因此,出现了一个新的心脏病学分支,即“肿瘤心脏病学”,旨在预防与抗肿瘤治疗相关的心血管并发症,实现任何并发症的早期诊断和治疗,并允许完成预期的抗肿瘤治疗。负荷超声心动图在及时诊断冠状动脉疾病方面发挥着关键作用,因此是这种临床情况下的最佳管理方法。在癌症患者中,化疗和胸部放疗均可加剧动脉粥样硬化过程,即使在抗癌治疗完成多年后也是如此。此外,负荷超声心动图还有许多其他潜在的应用,例如在评估接受有潜在心肌损伤风险的抗癌药物治疗的患者的亚临床左心室功能和收缩储备,以及评估瓣膜疾病。本综述的目的是阐述负荷超声心动图在肿瘤心脏病学中的作用。