Heart Failure Unit, Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, Lodz, 93-338, Poland.
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
ESC Heart Fail. 2021 Aug;8(4):2397-2418. doi: 10.1002/ehf2.13365. Epub 2021 May 5.
The most common cancer diagnosis in female population is breast cancer, which affects every year about 2.0 million women worldwide. In recent years, significant progress has been made in oncological therapy, in systemic treatment, and in radiotherapy of breast cancer. Unfortunately, the improvement in the effectiveness of oncological treatment and prolonging patients' life span is associated with more frequent occurrence of organ complications, which are side effects of this treatment. Current recommendations suggest a periodic monitoring of the cardiovascular system in course of oncological treatment. The monitoring includes the assessment of occurrence of risk factors for cardiovascular diseases in combination with the evaluation of the left ventricular systolic function using echocardiography and electrocardiography as well as with the analysis of the concentration of cardiac biomarkers. The aim of this review was critical assessment of the breast cancer therapy cardiotoxicity and the analysis of methods its detections. The new cardio-specific biomarkers in serum, the development of modern imaging techniques (Global Longitudinal Strain and Three-Dimensional Left Ventricular Ejection Fraction) and genotyping, and especially their combined use, may become a useful tool for identifying patients at risk of developing cardiotoxicity, who require further cardiovascular monitoring or cardioprotective therapy.
女性人群中最常见的癌症诊断是乳腺癌，全世界每年约有 200 万女性受到影响。近年来，在肿瘤治疗、系统治疗和乳腺癌放疗方面取得了重大进展。不幸的是，肿瘤治疗效果的提高和患者寿命的延长与器官并发症的更频繁发生有关，这些并发症是这种治疗的副作用。目前的建议建议在肿瘤治疗过程中定期监测心血管系统。监测包括评估心血管疾病危险因素的发生情况，结合超声心动图和心电图评估左心室收缩功能，并分析心脏生物标志物的浓度。本综述的目的是批判性评估乳腺癌治疗的心脏毒性，并分析其检测方法。血清中的新型心脏特异性生物标志物、现代成像技术（整体纵向应变和三维左心室射血分数）的发展以及基因分型，特别是它们的联合使用，可能成为识别发生心脏毒性风险的患者的有用工具，这些患者需要进一步进行心血管监测或心脏保护治疗。
