Department of Clinical and Molecular Medicine, Sapienza University of Rome, 1035-1039 Rome, Italy.
Med Sci (Basel). 2022 May 25;10(2):27. doi: 10.3390/medsci10020027.
Cardiovascular diseases are largely represented in patients with cancer and appear to be important side effects of cancer treatments, heavily affecting quality of life and leading to premature morbidity and death among cancer survivors. In particular, treatments for breast cancer have been shown to potentially play serious detrimental effects on cardiovascular health. This review aims to explore the available literature on breast cancer therapy-induced side effects on heart and vessels, illustrating the molecular mechanisms of cardiotoxicity known so far. Moreover, principles of cardiovascular risk assessment and management of cardiotoxicity in clinical practice will also be elucidated. Chemotherapy (anthracycline, taxanes, cyclophosphamide and 5-fluorouracil), hormonal therapy (estrogen receptor modulator and gonadotropin or luteinizing releasing hormone agonists) and targeted therapy (epidermal growth factor receptor 2 and Cyclin-dependent kinases 4 and 6 inhibitors) adverse events include arterial and pulmonary hypertension, supraventricular and ventricular arrhythmias, systolic and diastolic cardiac dysfunction and coronary artery diseases due to different and still not well-dissected molecular pathways. Therefore, cardiovascular prevention programs and treatment of cardiotoxicity appear to be crucial to improve morbidity and mortality of cancer survivors.
心血管疾病在癌症患者中占很大比例，似乎是癌症治疗的重要副作用，严重影响生活质量，并导致癌症幸存者过早发病和死亡。特别是，乳腺癌的治疗已被证明可能对心血管健康产生严重的不良影响。本综述旨在探讨乳腺癌治疗引起的心脏和血管副作用的现有文献，阐明迄今为止已知的心肌毒性的分子机制。此外，还将阐明心血管风险评估和临床实践中心肌毒性管理的原则。化疗（蒽环类药物、紫杉烷类药物、环磷酰胺和 5-氟尿嘧啶）、激素治疗（雌激素受体调节剂和促性腺激素或黄体生成素释放激素激动剂）和靶向治疗（表皮生长因子受体 2 和细胞周期蛋白依赖性激酶 4 和 6 抑制剂）的不良反应包括动脉和肺动脉高压、室上性和室性心律失常、收缩和舒张性心脏功能障碍以及冠状动脉疾病，这是由于不同且尚未充分阐明的分子途径所致。因此，心血管预防计划和心肌毒性的治疗似乎对于改善癌症幸存者的发病率和死亡率至关重要。
