Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Department of Cardio-Oncology, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK.
Eur Heart J Cardiovasc Imaging. 2021 Mar 22;22(4):383-396. doi: 10.1093/ehjci/jeaa345.
Advances in cancer therapy have led to significantly longer cancer-free survival times over the last 40 years. Improved survivorship coupled with increasing recognition of an expanding range of adverse cardiovascular effects of many established and novel cancer therapies has highlighted the impact of cardiovascular disease in this population. This has led to the emergence of dedicated cardio-oncology services that can provide pre-treatment risk stratification, surveillance, diagnosis, and monitoring of cardiotoxicity during cancer therapies, and late effects screening following completion of treatment. Cardiovascular imaging and the development of imaging biomarkers that can accurately and reliably detect pre-clinical disease and enhance our understanding of the underlying pathophysiology of cancer treatment-related cardiotoxicity are becoming increasingly important. Multi-parametric cardiovascular magnetic resonance (CMR) is able to assess cardiac structure, function, and provide myocardial tissue characterization, and hence can be used to address a variety of important clinical questions in the emerging field of cardio-oncology. In this review, we discuss the current and potential future applications of CMR in the investigation and management of cancer patients.
在过去的 40 年中，癌症治疗的进展使得癌症患者无病生存时间显著延长。生存时间的延长，加上人们越来越认识到许多已确立和新型癌症治疗方法会产生广泛的不良心血管影响，突显了心血管疾病在这一人群中的影响。这导致了专门的肿瘤心脏病学服务的出现，这些服务可以在癌症治疗前进行风险分层、监测、诊断和监测心脏毒性，并在治疗完成后进行晚期效应筛查。心血管成像和成像生物标志物的发展，这些标志物可以准确可靠地检测临床前疾病，并增强我们对癌症治疗相关心脏毒性的潜在病理生理学的理解，变得越来越重要。多参数心血管磁共振（CMR）能够评估心脏结构、功能，并提供心肌组织特征，因此可用于解决肿瘤心脏病学这一新兴领域中的各种重要临床问题。在这篇综述中，我们讨论了 CMR 在癌症患者的检查和管理中的当前和潜在的未来应用。
