Zhang Z R
Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, NHC Key Laboratory of Cell Transplantation, Harbin Medical University, Harbin 150086, China.
Zhonghua Yi Xue Za Zhi. 2023 Nov 14;103(42):3328-3331. doi: 10.3760/cma.j.cn112137-20230817-00243.
Cardiovascular disease (CVD) and cancer are two intimately interconnected conditions with leading causes of mortality worldwide. Emerging evidence suggests that CVD and cancer have common risk factors and share genetics and molecular mechanisms. With recent advancements in diagnosis and treatment, the number of long-term survivors have been continuously increasing. However, cancer patients have significantly higher cardiovascular mortality than general population, mostly resulting from cardiotoxic side effects of anticancer treatments. The prevalence and severity of cardiotoxicity and vascular abnormalities led to the emergence of a clinical branch of cardiology, known as cardio-oncology. Immune checkpoint inhibitors (ICIs) are currently widely used for treatment of various types of cancers. Recent studies suggest that ICIs lead to cardiotoxicity including myocarditis with an incidence of 0.04%-2.4% and a mortality of 25%-50%. However, the molecular and pathophysiologic mechanisms underlying the cardiovascular toxicity induced by ICIs are poorly understood. Therefore, this article combines the recent research results of the pathophysiology of cardiovascular toxicity induced by ICIs and explores novel diagnostic, monitoring, and therapeutic approaches to improve cardiac function and prevent cardiovascular injury.
心血管疾病（CVD）和癌症是全球两大主要死因，二者紧密相连。新出现的证据表明，CVD和癌症具有共同的风险因素，且在遗传和分子机制方面存在共性。随着诊断和治疗技术的不断进步，长期存活者的数量持续增加。然而，癌症患者的心血管死亡率显著高于普通人群，这主要是由抗癌治疗的心脏毒性副作用所致。心脏毒性和血管异常的发生率及严重程度促使了心脏病学一个临床分支——心脏肿瘤学的出现。免疫检查点抑制剂（ICIs）目前广泛用于治疗各类癌症。近期研究表明，ICIs会导致心脏毒性，包括心肌炎，其发生率为0.04% - 2.4%，死亡率为25% - 50%。然而，ICIs诱发心血管毒性的分子和病理生理机制仍知之甚少。因此，本文结合了ICIs诱发心血管毒性病理生理学的最新研究成果，探索改善心脏功能和预防心血管损伤的新型诊断、监测及治疗方法。
