Canale Maria Laura, Turazza Fabio, Lestuzzi Chiara, Parrini Iris, Camerini Andrea, Russo Giulia, Colivicchi Furio, Gabrielli Domenico, Gulizia Michele Massimo, Oliva Stefano, Tarantini Luigi, Maurea Nicola, Rigacci Luigi, Petrolati Sandro, Casolo Giancarlo, Bisceglia Irma
Division of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, Lido di Camaiore, Italy.
Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Front Cardiovasc Med. 2021 Jun 16;8:677544. doi: 10.3389/fcvm.2021.677544. eCollection 2021.
Cardio-oncology has achieved a pivotal role in science, but real world data on its clinical impact are still limited. A questionnaire was sent out to all cardio-oncology services across Italy ( = 120). The questionnaire was made up of 28 questions divided into four blocks: (A) general information on hospitals and service, (B) the inner organization of cardio-oncology and its relationships with out-of-hospital cardiologists and general practitioners, (C) educational needs and referral guidelines, and (D) activities/specific workload. Ninety-six out of 120 (80%) completed the questionnaire; 9.4% were cancer centers while 90.6% were general hospitals. A cardio-oncology team was present in 56% of the cancer centers and in 20% only of general hospitals, and a cardio-oncology pathway was active in 55% of cancer centers and in just 14% of the general hospitals. Relationships with out-of-hospital cardiologists and general practitioners were lacking. The guidelines of reference were ESC and ANMCO/AIOM. Patients receiving anthracycline chemotherapy underwent scheduled monitoring by means of echocardiography in 58% of cases. Routine use of cardiac damage biomarkers was overall low, ranging from 22 to 33% while the use of global longitudinal strain reached 44%. Italian cardio-oncology showed a growing influence on clinical practice but still has room for improvement. Cardio-oncology teams are still scarce, and the application of dedicated paths is poor. The need for specific training has been highlighted.
心脏肿瘤学在科学领域已发挥关键作用,但关于其临床影响的真实世界数据仍然有限。我们向意大利所有的心脏肿瘤学服务机构(共120家)发放了一份调查问卷。该问卷由28个问题组成,分为四个板块:(A)医院和服务的基本信息,(B)心脏肿瘤学的内部组织及其与院外心脏病专家和全科医生的关系,(C)教育需求和转诊指南,以及(D)活动/具体工作量。120家机构中有96家(80%)完成了问卷;其中9.4%是癌症中心,90.6%是综合医院。56%的癌症中心设有心脏肿瘤学团队,而综合医院中只有20%设有该团队;55%的癌症中心有活跃的心脏肿瘤学诊疗路径,而综合医院中仅有14%有此路径。与院外心脏病专家和全科医生缺乏联系。参考的指南是欧洲心脏病学会(ESC)和意大利心脏病学国家协会/意大利肿瘤内科学会(ANMCO/AIOM)的指南。接受蒽环类化疗的患者中,58%的病例通过超声心动图进行定期监测。心脏损伤生物标志物的常规使用率总体较低,在22%至33%之间,而整体纵向应变的使用率达到44%。意大利的心脏肿瘤学对临床实践的影响日益增强,但仍有改进空间。心脏肿瘤学团队仍然稀缺,专用诊疗路径的应用情况不佳。已凸显出对特定培训的需求。