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当前的心脏肿瘤学观点:流行病学、不良影响、治疗前筛查和预防策略。

Current perspectives of cardio-oncology: Epidemiology, adverse effects, pre-treatment screening and prevention strategies.

机构信息

1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.

出版信息

Cancer Med. 2023 Jul;12(13):14545-14555. doi: 10.1002/cam4.5980. Epub 2023 Apr 27.

Abstract

Cancer and cardiac diseases are the most prevalent causes of death in most developed countries. Due to the earlier detection and higher effectiveness of treatment, more patients survive the disease and have a long life expectancy. As the post-cancer population is growing, an increasing number of patients will be diagnosed with sequelae of those therapies, most often affecting the cardiovascular system. Although the risk of cancer recurrence decreases within years, the risk of cardiac complications-for example left ventricle (LV) systolic and diastolic dysfunction, arterial hypertension, arrhythmias, pericardial effusion and premature coronary artery disease remains elevated for decades after the completion of the therapy. The most common anticancer therapies that can cause adverse cardiovascular effects include chemotherapy-in particular anthracyclines, human epidermal growth receptor 2 targeted drugs and radiation therapy. A new field of research, cardio-oncology, addresses this increasing risk, screening, diagnosis and prevention. This review aims to present the most relevant reports regarding the adverse cardiac effects of oncological therapy, including the most prevalent types of cardiotoxicity, methods of pre-treatment screening and indications for prevention therapy.

摘要

在大多数发达国家,癌症和心脏病是最常见的死亡原因。由于早期检测和治疗效果的提高,越来越多的患者能够幸存下来,并且具有较长的预期寿命。随着癌症患者人数的增加,越来越多的患者将被诊断出患有这些治疗方法的后遗症,这些后遗症通常影响心血管系统。尽管癌症复发的风险在数年内降低,但心脏并发症的风险——例如左心室(LV)收缩和舒张功能障碍、动脉高血压、心律失常、心包积液和早发冠心病——在治疗完成后数十年内仍然很高。最常见的可能导致不良心血管影响的抗癌治疗方法包括化疗——特别是蒽环类药物、人表皮生长因子 2 靶向药物和放射治疗。一个新的研究领域,即肿瘤心脏病学,针对这一日益增加的风险进行了筛查、诊断和预防。本综述旨在介绍关于肿瘤治疗相关不良心脏影响的最相关报告,包括最常见的几种类型的心脏毒性、治疗前筛查方法和预防治疗的适应证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb7d/10358193/c1f5d0a36aa5/CAM4-12-14545-g001.jpg

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