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癌症治疗所致心脏毒性的多模态心血管成像

Multimodality Cardiovascular Imaging of Cardiotoxicity Due to Cancer Therapy.

作者信息

Contaldi Carla, Montesarchio Vincenzo, Catapano Dario, Falco Luigi, Caputo Francesca, D'Aniello Carmine, Masarone Daniele, Pacileo Giuseppe

机构信息

Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital, 80131 Naples, Italy.

Division of Medical Oncology, AORN dei Colli-Monaldi Hospital, 80131 Naples, Italy.

出版信息

Life (Basel). 2023 Oct 23;13(10):2103. doi: 10.3390/life13102103.

Abstract

Cancer therapies have revolutionized patient survival rates, yet they come with the risk of cardiotoxicity, necessitating effective monitoring and management. The existing guidelines offer a limited empirical basis for practical approaches in various clinical scenarios. This article explores the intricate relationship between cancer therapy and the cardiovascular system, highlighting the role of advanced multimodality imaging in monitoring patients before, during, and after cancer treatment. This review outlines the cardiovascular effects of different cancer therapy classes, offering a comprehensive understanding of their dose- and time-dependent impacts. This paper delves into diverse imaging modalities such as echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, and nuclear imaging, detailing their strengths and limitations in various conditions due to cancer treatment, such as cardiac dysfunction, myocarditis, coronary artery disease, Takotsubo cardiomyopathy, pulmonary hypertension, arterial hypertension, valvular heart diseases, and heart failure with preserved ejection fraction. Moreover, it underscores the significance of long-term follow-up for cancer survivors and discusses future directions.

摘要

癌症治疗彻底改变了患者的生存率,但它们伴有心脏毒性风险,因此需要进行有效的监测和管理。现有指南为各种临床场景中的实际方法提供的经验基础有限。本文探讨了癌症治疗与心血管系统之间的复杂关系,强调了先进的多模态成像在癌症治疗前、治疗期间和治疗后监测患者方面的作用。这篇综述概述了不同类型癌症治疗对心血管系统的影响,全面了解其剂量和时间依赖性影响。本文深入探讨了多种成像方式,如超声心动图、心脏磁共振成像、心脏计算机断层扫描和核成像,详细阐述了它们在因癌症治疗导致的各种病症(如心脏功能障碍、心肌炎、冠状动脉疾病、Takotsubo心肌病、肺动脉高压、动脉高血压、心脏瓣膜病和射血分数保留的心力衰竭)中的优势和局限性。此外,它强调了对癌症幸存者进行长期随访的重要性,并讨论了未来的方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c65f/10608651/68ec6762d232/life-13-02103-g001.jpg

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