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乳腺癌与心血管健康。

Breast cancer and cardiovascular health.

机构信息

Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain.

Cardiology Department, Quironsalud University Hospital, C. Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Madrid, Spain.

出版信息

Eur Heart J. 2024 Nov 7;45(41):4366-4382. doi: 10.1093/eurheartj/ehae637.

Abstract

Modern cancer therapies greatly improve clinical outcomes for both early and advanced breast cancer patients. However, these advances have raised concerns about potential short- and long-term toxicities, including cardiovascular toxicities. Therefore, understanding the common risk factors and underlying pathophysiological mechanisms contributing to cardiovascular toxicity is essential to ensure best breast cancer outcomes. While cardio-oncology has emerged as a sub-speciality to address these challenges, it is essential that all cardiologists recognize and understand the cardiovascular consequences of cancer therapy. This review aims to provide a comprehensive overview of the potential adverse cardiovascular effects associated with modern breast cancer therapies. A preventive, diagnostic, and therapeutic workflow to minimize the impact of cardiovascular toxicity on patient outcomes is presented. Key aspects of this workflow include regular monitoring of cardiovascular function, early detection and management of cancer therapy-related cardiovascular toxicities, and optimization of cardiovascular risk factor control. By highlighting the gaps in knowledge in some areas, this review aims to emphasize the critical role of cardio-oncology research in ensuring the holistic well-being of patients with breast cancer.

摘要

现代癌症疗法极大地改善了早期和晚期乳腺癌患者的临床预后。然而,这些进展引发了人们对潜在的短期和长期毒性的担忧,包括心血管毒性。因此,了解导致心血管毒性的常见风险因素和潜在病理生理机制对于确保最佳的乳腺癌治疗结果至关重要。虽然肿瘤心脏病学已成为应对这些挑战的一个亚专科,但所有心脏病专家都必须认识并了解癌症治疗的心血管后果。本篇综述旨在全面概述与现代乳腺癌治疗相关的潜在不良心血管影响。提出了一种预防、诊断和治疗工作流程,以最大限度地减少心血管毒性对患者结局的影响。该工作流程的关键方面包括定期监测心血管功能、早期发现和管理癌症治疗相关的心血管毒性以及优化心血管危险因素的控制。通过突出一些领域知识的差距,本篇综述旨在强调肿瘤心脏病学研究在确保乳腺癌患者整体健康方面的关键作用。

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