Mohananey Divyanshu, Sarau Alexandra, Kumar Rohit, Lewandowski David, Abreu-Sosa Sol M, Nathan Sunita, Okwuosa Tochukwu M
Department of Cardiovascular Medicine, Medical College of Wisconsin, Wisconsin, USA.
Department of Internal Medicine, Rush University, Chicago, Illinois, USA.
JACC CardioOncol. 2021 Mar 16;3(1):17-34. doi: 10.1016/j.jaccao.2021.01.008. eCollection 2021 Mar.
Hematopoietic stem cell transplantation (HSCT) is a standard treatment for several malignancies, and >50,000 HSCT are performed annually worldwide. As survival after HSCT improves, cardiovascular disease and associated risk factors have gained importance as a significant cause of morbidity and mortality in this cohort. In this article, we detail the risk factors for cardiovascular disease and their impact in patients undergoing HSCT. Additionally, we critically review the data on the impact of physical exercise in patients undergoing HSCT. Although limited by significant heterogeneity in methodologies, small sample sizes, attrition, and lack of long-term cardiovascular follow-up, most of these studies reinforce the beneficial effects of physical activity and exercise in this patient population. Cardiac rehabilitation (CR) is a structured exercise and lifestyle modification program that is typically instituted in patients who experience acute cardiovascular events. We review the data on CR in the oncologic and nononcologic populations with an aim of building a framework for use of CR in HSCT patients.
造血干细胞移植(HSCT)是多种恶性肿瘤的标准治疗方法,全球每年进行超过50000例HSCT。随着HSCT后生存率的提高,心血管疾病及相关危险因素已成为该队列中发病和死亡的重要原因。在本文中,我们详细阐述了心血管疾病的危险因素及其对接受HSCT患者的影响。此外,我们批判性地回顾了体育锻炼对接受HSCT患者影响的数据。尽管这些研究受到方法显著异质性、样本量小、失访以及缺乏长期心血管随访的限制,但大多数研究都证实了体育活动和锻炼对该患者群体的有益影响。心脏康复(CR)是一项结构化的运动和生活方式改变计划,通常适用于经历急性心血管事件的患者。我们回顾了肿瘤学和非肿瘤学人群中CR的数据,旨在建立一个在HSCT患者中使用CR的框架。