Michel Lars, Rassaf Tienush
Dtsch Med Wochenschr. 2022 Nov;147(23):1513-1522. doi: 10.1055/a-1810-9275. Epub 2022 Nov 16.
Drug-induced cardiovascular side effects have a significant impact on morbidity and mortality. The demographic change and improved long-term survival particularly in cancer patients have caused an increasing number of affected patients, hence emphasizing the importance of the best possible treatment of such complications. This article gives an overview of classic and modern groups of substances with cardiotoxic effects and summarizes the principles of diagnostics and therapy. After characterizing the common cardiovascular side effects caused by anthracycline chemotherapy, we focus on complications caused by modern forms of immunotherapy, considering its significant impact on oncological therapy in the future due to its growing clinical application. In addition to specific cancer therapies, accompanying measures such as blood transfusions in patients with hematologic diseases can also lead to severe cardiovascular complications. In the last section, we classify important features and therapeutic approaches in cardiac involvement of transfusion-related hemochromatosis. A good knowledge of the characteristics of specific cardiovascular side effects can help to improve the management of affected patients.
药物引起的心血管副作用对发病率和死亡率有重大影响。人口结构变化以及尤其是癌症患者长期生存率的提高,导致受影响患者数量不断增加,因此凸显了对这类并发症进行最佳治疗的重要性。本文概述了具有心脏毒性作用的经典和现代药物类别,并总结了诊断和治疗原则。在描述了蒽环类化疗引起的常见心血管副作用后,鉴于现代免疫疗法在临床应用中不断增加,对肿瘤治疗未来具有重大影响,我们将重点关注其引起的并发症。除了特定的癌症治疗外,血液系统疾病患者输血等伴随措施也可能导致严重的心血管并发症。在最后一部分,我们对输血相关血色素沉着症心脏受累的重要特征和治疗方法进行了分类。深入了解特定心血管副作用的特征有助于改善对受影响患者的管理。