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化疗相关心脏毒性评估——聚焦心脏成像的当代综述

Chemotherapy Related Cardiotoxicity Evaluation-A Contemporary Review with a Focus on Cardiac Imaging.

作者信息

Scalia Isabel G, Gheyath Bashaer, Tamarappoo Balaji K, Moudgil Rohit, Otton James, Pereyra Milagros, Narayanasamy Hema, Larsen Carolyn, Herrmann Joerg, Arsanjani Reza, Ayoub Chadi

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.

Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA.

出版信息

J Clin Med. 2024 Jun 26;13(13):3714. doi: 10.3390/jcm13133714.

Abstract

The long-term survivorship of patients diagnosed with cancer has improved due to accelerated detection and rapidly evolving cancer treatment strategies. As such, the evaluation and management of cancer therapy related complications has become increasingly important, including cardiovascular complications. These have been captured under the umbrella term "cardiotoxicity" and include left ventricular dysfunction and heart failure, acute coronary syndromes, valvular abnormalities, pericardial disease, arrhythmia, myocarditis, and vascular complications. These complications add to the burden of cardiovascular disease (CVD) or are risk factors patients with cancer treatment are presenting with. Of note, both pre- and newly developing CVD is of prognostic significance, not only from a cardiovascular perspective but also overall, potentially impacting the level of cancer therapy that is possible. Currently, there are varying recommendations and practices regarding CVD risk assessment and mitigating strategies throughout the cancer continuum. This article provides an overview on this topic, in particular, the role of cardiac imaging in the care of the patient with cancer. Furthermore, it summarizes the current evidence on the spectrum, prevention, and management of chemotherapy-related adverse cardiac effects.

摘要

由于癌症检测的加速和癌症治疗策略的迅速发展,被诊断为癌症的患者的长期生存率有所提高。因此,癌症治疗相关并发症的评估和管理变得越来越重要,包括心血管并发症。这些并发症被统称为“心脏毒性”,包括左心室功能障碍和心力衰竭、急性冠状动脉综合征、瓣膜异常、心包疾病、心律失常、心肌炎和血管并发症。这些并发症增加了心血管疾病(CVD)的负担,或者是癌症治疗患者出现的危险因素。值得注意的是,既往存在的和新发生的CVD都具有预后意义,不仅从心血管角度来看,而且从整体来看,都可能影响可行的癌症治疗水平。目前,在整个癌症治疗过程中,关于CVD风险评估和缓解策略有不同的建议和做法。本文提供了关于这个主题的概述,特别是心脏成像在癌症患者护理中的作用。此外,它总结了目前关于化疗相关不良心脏影响的范围、预防和管理的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0744/11242267/d8ad6ca6b938/jcm-13-03714-g001.jpg

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