Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USA.
Cardiology. 2023;148(4):324-334. doi: 10.1159/000529260. Epub 2023 Jan 26.
Advances in cancer therapeutics have improved overall survival and prognosis in this patient population; however, this has come at the expense of cardiotoxicity including arrhythmia.
Cancer and its therapies are associated with cardiotoxicity via several mechanisms including inflammation, cardiomyopathy, and off-target effects. Among cancer therapies, anthracyclines and tyrosine kinase inhibitors (TKIs) are particularly known for their pro-arrhythmia effects. In addition to cardiomyopathy, anthracyclines may be pro-arrhythmogenic via reactive oxygen species (ROS) generation and altered calcium handling. TKIs may mediate their cardiotoxicity via inhibition of off-target tyrosine kinases. Ibrutinib-mediated inhibition of CSK may be responsible for the increased prevalence of atrial fibrillation. Further investigation is warranted to further elucidate the mechanisms behind arrhythmias in cancer therapies.
Arrhythmias are a common cardiotoxicity of cancer therapies. Cancer therapies may induce arrhythmias via off-target effects. Understanding the mechanisms underlying arrhythmogenesis associated with cancer therapies may help design cancer therapies that can avoid these toxicities.
癌症治疗的进步改善了这一患者群体的总体生存率和预后；然而，这是以心脏毒性（包括心律失常）为代价的。
癌症及其治疗方法通过多种机制导致心脏毒性，包括炎症、心肌病和非靶向作用。在癌症治疗方法中，蒽环类药物和酪氨酸激酶抑制剂（TKI）特别以其致心律失常作用而闻名。除了心肌病，蒽环类药物可能通过活性氧（ROS）生成和钙处理改变而具有致心律失常作用。TKI 可能通过抑制非靶向酪氨酸激酶来介导其心脏毒性。伊布替尼介导的 CSK 抑制可能是心房颤动患病率增加的原因。需要进一步研究以进一步阐明癌症治疗中心律失常的机制。
心律失常是癌症治疗的常见心脏毒性。癌症治疗方法可能通过非靶向作用引起心律失常。了解与癌症治疗相关的心律失常发生机制可能有助于设计可避免这些毒性的癌症治疗方法。
