Tavernese Annamaria, Cammalleri Valeria, Mollace Rocco, Antonelli Giorgio, Piscione Mariagrazia, Cocco Nino, Carpenito Myriam, Dominici Carmelo, Federici Massimo, Ussia Gian Paolo
Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy.
Operative Research Unit of Emodinamica, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy.
J Cardiovasc Dev Dis. 2024 Dec 29;12(1):9. doi: 10.3390/jcdd12010009.
Cardiac involvement in cancer is increasingly important in the diagnosis and follow-up of patients. A thorough cardiovascular evaluation using multimodal imaging is crucial to assess any direct cardiac involvement from oncological disease progression and to determine the cardiovascular risk of patients undergoing oncological therapies. Early detection of cardiac dysfunction, particularly due to cardiotoxicity from chemotherapy or radiotherapy, is essential to establish the disease's overall prognostic impact. Comprehensive cardiovascular imaging should be integral to the clinical management of cancer patients. Echocardiography remains highly effective for assessing cardiac function, including systolic performance and ventricular filling pressures, with speckle-tracking echocardiography offering early insights into chemotoxicity-related myocardial damage. Cardiac computed tomography (CT) provides precise anatomical detail, especially for cardiac involvement due to metastasis or adjacent mediastinal or lung tumors. Coronary assessment is also important for initial risk stratification and monitoring potential coronary artery disease progression after radiotherapy or chemotherapeutic treatment. Finally, cardiac magnetic resonance (CMR) is the gold standard for myocardial tissue characterization, aiding in the differential diagnosis of cardiac masses. CMR's mapping techniques allow for early detection of myocardial inflammation caused by cardiotoxicity. This review explores the applicability of echocardiography, cardiac CT, and CMR in cancer patients with extracardiac tumors.
心脏受累在癌症患者的诊断和随访中日益重要。使用多模态成像进行全面的心血管评估对于评估肿瘤疾病进展导致的任何直接心脏受累以及确定接受肿瘤治疗患者的心血管风险至关重要。早期发现心脏功能障碍,尤其是由于化疗或放疗引起的心脏毒性,对于确定该疾病的总体预后影响至关重要。全面的心血管成像应成为癌症患者临床管理的组成部分。超声心动图对于评估心脏功能(包括收缩功能和心室充盈压)仍然非常有效,斑点追踪超声心动图可早期洞察与化学毒性相关的心肌损伤。心脏计算机断层扫描(CT)提供精确的解剖细节,特别是对于因转移或相邻纵隔或肺部肿瘤导致的心脏受累情况。冠状动脉评估对于初始风险分层以及监测放疗或化疗后潜在冠状动脉疾病的进展也很重要。最后,心脏磁共振(CMR)是心肌组织特征化的金标准,有助于心脏肿块的鉴别诊断。CMR的成像技术可早期发现由心脏毒性引起的心肌炎症。本综述探讨了超声心动图、心脏CT和CMR在患有心外肿瘤的癌症患者中的适用性。
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