Vuong Jacqueline T, Stein-Merlob Ashley F, Cheng Richard K, Yang Eric H
Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.
Division of Cardiology, Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.
Front Cardiovasc Med. 2022 Apr 22;9:863314. doi: 10.3389/fcvm.2022.863314. eCollection 2022.
Anthracyclines remain an essential component of the treatment of many hematologic and solid organ malignancies, but has important implications on cardiovascular disease. Anthracycline induced cardiotoxicity (AIC) ranges from asymptomatic LV dysfunction to highly morbid end- stage heart failure. As cancer survivorship improves, the detection and treatment of AIC becomes more crucial to improve patient outcomes. Current treatment modalities for AIC have been largely extrapolated from treatment of conventional heart failure, but developing effective therapies specific to AIC is an area of growing research interest. This review summarizes the current evidence behind the use of neurohormonal agents, dexrazoxane, and resynchronization therapy in AIC, evaluates the clinical outcomes of advanced therapy and heart transplantation in AIC, and explores future horizons for treatment utilizing gene therapy, stem cell therapy, and mechanism-specific targets.
蒽环类药物仍然是许多血液系统和实体器官恶性肿瘤治疗的重要组成部分,但对心血管疾病有重要影响。蒽环类药物诱导的心脏毒性(AIC)范围从无症状左心室功能障碍到高发病率的终末期心力衰竭。随着癌症生存率的提高,AIC的检测和治疗对于改善患者预后变得更加关键。目前AIC的治疗方式很大程度上是从传统心力衰竭的治疗中推断出来的,但开发针对AIC的有效疗法是一个研究兴趣日益浓厚的领域。本综述总结了在AIC中使用神经激素药物、右丙亚胺和再同步治疗背后的当前证据,评估了AIC中晚期治疗和心脏移植的临床结果,并探索了利用基因治疗、干细胞治疗和机制特异性靶点进行治疗的未来前景。