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抗癌药物所致心脏毒性的管理与治疗:10个问答

Management and treatment of cardiotoxicity due to anticancer drugs: 10 questions and answers.

作者信息

Chianca Michela, Fabiani Iacopo, Del Franco Annamaria, Grigoratos Chrysanthos, Aimo Alberto, Panichella Giorgia, Giannoni Alberto, Castiglione Vincenzo, Gentile Francesco, Passino Claudio, Cipolla Carlo Maria, Cardinale Daniela Maria, Emdin Michele

机构信息

Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa 56127, Italy.

Cardiology Division, Fondazione Toscana Gabriele Monasterio, Viale G. Moruzzi, 1-56100 Pisa, Italy.

出版信息

Eur J Prev Cardiol. 2022 Dec 7;29(17):2163-2172. doi: 10.1093/eurjpc/zwac170.

Abstract

Since the introduction of anthracyclines into clinical practice in the 1960s, chemotherapy has always been associated with cardiotoxicity. Patients on cardiotoxic drugs can develop a wide range of cardiovascular diseases, including left ventricular (LV) systolic dysfunction and heart failure (HF), arrhythmias, hypertension, and coronary artery disease (CAD). The rising number of cancer patients, population ageing, and the frequent overlap of cardiovascular and oncological diseases have highlighted the importance of close collaboration between cardiologists and oncologists. As a result, in 1995, cardiologists at the IEO (European Institute of Oncology) coined the term cardioncology, a new discipline focused on the dynamics of cardiovascular disease in cancer patients. Given the complex scenario characterized by a constant dialogue between the oncological condition and cardiovascular comorbidity, it is essential for the clinician to get the knowledge to properly fulfill the needs of the oncological patient under cardiotoxic treatment. Through the answer to 10 questions, we aim to describe the complex issue of cardiotoxicity by addressing the main critical points and current evidence related to the assessment, management, treatment, and surveillance of cancer patients under chemotherapy.

摘要

自20世纪60年代蒽环类药物引入临床实践以来,化疗一直与心脏毒性相关。使用具有心脏毒性药物的患者可能会患上多种心血管疾病,包括左心室(LV)收缩功能障碍和心力衰竭(HF)、心律失常、高血压和冠状动脉疾病(CAD)。癌症患者数量的增加、人口老龄化以及心血管疾病和肿瘤疾病的频繁重叠凸显了心脏病专家和肿瘤专家密切合作的重要性。因此,1995年,欧洲肿瘤研究所(IEO)的心脏病专家创造了“心脏肿瘤学”一词,这是一门专注于癌症患者心血管疾病动态的新学科。鉴于肿瘤病情与心血管合并症之间持续对话所呈现的复杂情况,临床医生掌握相关知识以妥善满足接受心脏毒性治疗的肿瘤患者的需求至关重要。通过回答10个问题,我们旨在通过阐述与化疗期间癌症患者的评估、管理、治疗和监测相关的主要关键点及当前证据,来描述心脏毒性这一复杂问题。

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