Spadafora Luigi, Di Muro Francesca Maria, Intonti Chiara, Massa Ludovica, Monelli Mauro, Pedretti Roberto Franco Enrico, Palazzo Adriano Edvige, Guarini Pasquale, Cantiello Gaia, Bernardi Marco, Russo Federico, Cacciatore Stefano, Sabouret Pierre, Golino Michele, Biondi Zoccai Giuseppe, Zimatore Francesca Romana, Dalla Vecchia Laura Adelaide
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Division of Cardiology and Interventional Cardiology, Santa Maria Goretti Hospital, 04100 Latina, Italy.
J Cardiovasc Dev Dis. 2025 Jun 4;12(6):212. doi: 10.3390/jcdd12060212.
Anthracyclines remain a cornerstone of cancer therapy but are associated with a significant risk of cardiotoxicity, which can lead to overt heart failure. The risk is modulated by cumulative dose, pre-existing cardiovascular disease, and patient-specific factors. As cancer survival improves, the long-term cardiovascular consequences of anthracycline exposure have become a growing concern, underscoring the need for effective preventive strategies. This narrative review examines lifestyle and pharmacological interventions aimed at mitigating anthracycline-induced cardiotoxicity. Evidence suggests that structured exercise programs and antioxidant-rich diets may enhance cardiovascular resilience, while beta-blockers, renin-angiotensin system inhibitors, and dexrazoxane remain central pharmacological options. Emerging therapies, including sodium-glucose co-transporter 2 inhibitors and sacubitril/valsartan, show promise but require further investigation. A comprehensive approach that integrates lifestyle modifications with pharmacological strategies within a multidisciplinary cardio-oncology framework may provide optimal protection, improving long-term cardiovascular outcomes in cancer patients receiving anthracyclines.
蒽环类药物仍然是癌症治疗的基石，但具有显著的心脏毒性风险，可导致明显的心衰。该风险受累积剂量、既往心血管疾病和患者特异性因素的调节。随着癌症生存率的提高，蒽环类药物暴露的长期心血管后果日益受到关注，这凸显了有效预防策略的必要性。这篇叙述性综述探讨了旨在减轻蒽环类药物所致心脏毒性的生活方式和药物干预措施。有证据表明，结构化运动计划和富含抗氧化剂的饮食可能增强心血管弹性，而β受体阻滞剂、肾素-血管紧张素系统抑制剂和右丙亚胺仍然是主要的药物选择。包括钠-葡萄糖协同转运蛋白2抑制剂和沙库巴曲/缬沙坦在内的新兴疗法显示出前景，但需要进一步研究。在多学科心脏肿瘤学框架内，将生活方式改变与药物策略相结合的综合方法可能提供最佳保护，改善接受蒽环类药物治疗的癌症患者的长期心血管结局。
