Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment.
Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment.
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DOI：
10.1186/s40959-017-0025-7
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发表时间：
2017-01-01
期刊：
影响因子：
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通讯作者：
Koczwara, Bogda
中科院分区：
文献类型：
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作者：
Clark, Robyn A;Marin, Tania S;Koczwara, Bogda
背景：抗癌治疗的心脏毒性影响心脏的功能和结构。心脏毒性也可以导致慢性疾病的加速发展，特别是在存在危险因素的情况下。方法：本研究旨在开发和试行心血管疾病和心脏毒性风险评估问卷，以量化乳腺癌患者治疗前危险因素的潜在程度。问卷由专家小组进行内容和表面效度评估，然后在乳腺癌患者样本(n=36)中进行试点测试。在一名研究助理在场的情况下，在化疗诊所就诊时自行填写问卷。结果：参与者的平均年龄为54.8岁(范围36-72岁)。参与者报告的心血管危险因素包括糖尿病2.8%，高血压19.8%，高胆固醇血症11%，睡眠呼吸暂停5%。生活方式危险因素，包括每天不吃推荐的蔬菜(100%)或水果(78%)；吸烟(13%)和经常饮酒(75%)。25%的人报告身体不活动，61%的人超重或肥胖，24%的人很少或没有社会支持，30%的人有很高到很高的心理痛苦。参与者非常(75%)不愿改变生活方式，即改变饮酒；饮食习惯；良好的情绪/心理健康策略；改善体力活动；戒烟；了解心脏健康和减肥。结论：这项研究是预防和管理乳腺癌诊断后与治疗相关的心脏毒性的重要一步。我们建议，我们的问卷提供了重要的数据，这些数据应该包括在癌症登记中，以便研究人员能够建立心血管疾病风险概况和心脏毒性结果之间的关系，并且这项研究揭示了重要的教学机会，可以用来检查对健康素养的影响，并帮助患者更好地了解癌症治疗的后果。
BACKGROUND: Cardiotoxicity from anticancer therapy affects heart function and structure. Cardiotoxicity can also lead to accelerated development of chronic diseases, especially in the presence of risk factors.METHODS: This study aimed to develop and pilot a combined cardiovascular disease and cardiotoxicity risk assessment questionnaire to quantify the potential extent of risk factors in breast cancer patients prior to treatment. The questionnaire underwent content and face validity evaluation by an expert panel followed by pilot testing in a sample of breast cancer patients (n=36). Questionnaires were self-administered while attending chemotherapy clinic, in the presence of a research assistant.RESULTS: Mean age of participants was 54.8years (range 36-72years). Participants reported CVD risk factors including diabetes 2.8%, hypertension 19.8%, hypercholesterolaemia 11% and sleep apnoea 5%. Lifestyle risk factors, included not eating the recommended serves of vegetables (100%) or fruit (78%) per day; smoking (13%) and regularly consuming alcohol (75%). Twenty five percent reported being physically inactive, 61%, overweight or obese, 24%, little or no social support and 30% recorded high to very high psychological distress. Participants were highly (75%) reluctant to undertake lifestyle changes; i.e. changing alcohol consumption; dietary habits; good emotional/mental health strategies; improving physical activity; quitting smoking; learning about heart-health and weight loss.CONCLUSION: This study is an important step towards prevention and management of treatment-associated cardiotoxicity after breast cancer diagnosis. We recommend that our questionnaire is providing important data that should be included in cancer registries so that researchers can establish the relationship between CVD risk profile and cardiotoxicity outcomes and that this study revealed important teaching opportunities that could be used to examine the impact on health literacy and help patients better understand the consequences of cancer treatment.