Tunuguntla Hari P, Puri Kriti, Denfield Susan W
Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
Children (Basel). 2021 Sep 30;8(10):872. doi: 10.3390/children8100872.
The evolution of cancer therapies has led to marked improvement in survival of those affected by childhood malignancies, while also increasing the recognition of early and late toxicities associated with cancer therapies. Cardiotoxicity can include cardiomyopathy/heart failure, coronary artery disease, stroke, pericardial disease, arrhythmias, and valvular and vascular dysfunction as a result of exposure to chemotherapy and/or radiation. Anthracyclines remain the most common cause of chemotherapy-induced cardiomyopathy (CCM) with varying clinical presentations including: acute, early onset, and late-onset. Many individuals develop cardiac dysfunction over the long-term, ranging from subclinical cardiac dysfunction to end-stage symptomatic heart failure. The focus of this review is on characterization of symptomatic heart failure in children with cancer therapy-related cardiac dysfunction (CTRCD) primarily due to CCM and utilization of advanced heart failure therapies, including ventricular assist device (VAD) support and heart transplantation, with consideration of unique patient-related factors.
癌症治疗的发展显著提高了儿童恶性肿瘤患者的生存率，同时也使人们越来越认识到癌症治疗相关的早期和晚期毒性。心脏毒性可能包括由于接触化疗和/或放疗而导致的心肌病/心力衰竭、冠状动脉疾病、中风、心包疾病、心律失常以及瓣膜和血管功能障碍。蒽环类药物仍然是化疗引起的心肌病（CCM）最常见的原因，其临床表现各异，包括急性、早发性和迟发性。许多人长期会出现心脏功能障碍，从亚临床心脏功能障碍到终末期有症状的心力衰竭。本综述的重点是主要由CCM导致的癌症治疗相关心脏功能障碍（CTRCD）患儿中症状性心力衰竭的特征，以及先进心力衰竭治疗方法的应用，包括心室辅助装置（VAD）支持和心脏移植，并考虑与患者相关的独特因素。
