Bansal Neha, Hazim Carol Fernandez, Badillo Sergio, Shyam Sharvari, Wolfe Diana, Bortnick Anna E, Garcia Mario J, Rodriguez Carols J, Zhang Lili
The Children's Heart Center, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Department of Medicine, Montefiore Medical Center, Bronx, New York, NY 10467, USA.
J Cardiovasc Dev Dis. 2022 Oct 31;9(11):373. doi: 10.3390/jcdd9110373.
This review focuses on the maternal cardiovascular risk and outcomes of pregnancy in childhood, adolescent, and young adult cancer survivors who are achieving survival to their prime reproductive years. Childhood, adolescent, and young adult cancer survivors are a growing population and have increasing needs for reproductive care over decades of life. Female cancer survivors have an overall higher risk of maternal cardiovascular events compared to those without a history of cancer. In female cancer survivors with normal cardiac function before pregnancy, the incidence of new heart failure during pregnancy is low. In survivors with cardiotoxicity prior to pregnancy, the risk of heart failure during and immediately after pregnancy is much higher. We recommend cardiomyopathy surveillance with echocardiography before pregnancy for all female survivors treated with anthracyclines and chest radiation. Survivors with cardiotoxicity prior to pregnancy should be cared for by an expert multidisciplinary team, including obstetrics, cardiology, anesthesia, and specialized nursing, among others.
本综述聚焦于童年、青少年及年轻成年癌症幸存者在步入最佳生育年龄并实现生存后的孕产妇心血管风险及妊娠结局。童年、青少年及年轻成年癌症幸存者群体不断壮大，在数十年的人生中对生殖保健的需求也日益增加。与无癌症病史者相比，女性癌症幸存者发生孕产妇心血管事件的总体风险更高。在妊娠前心功能正常的女性癌症幸存者中，孕期新发心力衰竭的发生率较低。在妊娠前存在心脏毒性的幸存者中，孕期及产后即刻发生心力衰竭的风险要高得多。我们建议，对所有接受过蒽环类药物治疗及胸部放疗的女性幸存者，在妊娠前采用超声心动图进行心肌病监测。妊娠前存在心脏毒性的幸存者应由包括产科、心脏病学、麻醉学及专业护理等在内的多学科专家团队进行护理。
