Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA. Electronic address: https://twitter.com/ElizabethBaloug.
Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; 3 Blackfan Circle, CLS-911, Boston, MA 02115, USA.
Cardiol Clin. 2025 Feb;43(1):111-127. doi: 10.1016/j.ccl.2024.08.002. Epub 2024 Oct 5.
Anthracycline chemotherapy is associated with cardiotoxicity, predominantly manifesting as left ventricular systolic dysfunction within the first year of treatment. Early detection is possible through biomarkers and cardiovascular imaging before clinical symptoms develop. Comprehensive cardiovascular risk assessment is essential for all patients prior to anthracycline therapy to stratify their risk of cardiotoxicity. Preventive measures, including cardiovascular risk optimization, as well as anthracycline dose adjustments, the use of liposomal anthracyclines, and dexrazoxane in high-risk patients, are crucial to mitigate the risk of cardiotoxicity. Long-term follow-up and cardiovascular risk optimization are critical for cancer survivors to optimize cardiovascular outcomes.
蒽环类化疗药物与心脏毒性相关，主要表现为治疗后 1 年内左心室收缩功能障碍。在出现临床症状之前，可以通过生物标志物和心血管成像进行早期检测。所有接受蒽环类化疗药物治疗的患者在开始治疗前都需要进行全面的心血管风险评估，以分层评估其心脏毒性风险。预防措施包括心血管风险优化、蒽环类药物剂量调整、使用脂质体蒽环类药物以及高危患者使用右雷佐生，这些都是降低心脏毒性风险的关键。癌症幸存者需要长期随访和心血管风险优化，以优化心血管结局。
