Cancer Therapy-Related Cardiac Dysfunction and Heart Failure: Part 1: Definitions, Pathophysiology, Risk Factors, and Imaging.
Cancer Therapy-Related Cardiac Dysfunction and Heart Failure: Part 1: Definitions, Pathophysiology, Risk Factors, and Imaging.
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DOI：
10.1161/circheartfailure.115.002661
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Butler J
中科院分区：
文献类型：
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作者：
Bloom MW;Hamo CE;Cardinale D;Ky B;Nohria A;Baer L;Skopicki H;Lenihan DJ;Gheorghiade M;Lyon AR;Butler J
癌症治疗的进展已经导致许多类型癌症的长期生存率的显著改善，但也导致与治疗相关的不良副作用。其中一种并发症是心肌病和心力衰竭的发展，这一点越来越被人们所认识。无论是从心血管角度来看以前健康的人发展出癌症治疗相关的心功能障碍，还是高风险心血管患者需要癌症治疗，肿瘤学家和心脏病学家团队都必须更好地配备循证方法来照顾这些患者。虽然与各种癌症治疗相关的毒性是公认的，但我们对适当行动方案的理解仍然存在局限性。在这篇2部分综述的第一部分中，我们讨论了癌症治疗相关的心功能不全和心力衰竭的流行病学、病理生理学、危险因素和影像学方面。在随后的第二部分，我们讨论了预防和治疗方面，最后一节的证据差距和未来的方向。我们专注于从治疗前监测到持续治疗和长期随访的所有癌症治疗阶段的成人患者。
Advances in cancer therapy have resulted in significant improvement in long-term survival for many types of cancer, but have also resulted in untoward side effects associated with treatment. One such complication that has become increasingly recognized is the development of cardiomyopathy and heart failure. Whether a previously healthy person from a cardiovascular perspective develops cancer therapy related cardiac dysfunction or a high-risk cardiovascular patient requires cancer therapy, the team of oncologists and cardiologists must be better equipped with an evidence-based approach to care for these patients across the spectrum. Although the toxicities associated with various cancer therapies are well recognized, limitations to our understanding of the appropriate course of action remain. In this first of a 2-part review, we discuss the epidemiologic, pathophysiologic, risk factors, and imaging aspects of cancer therapy related cardiac dysfunction and heart failure. In a subsequent second part, we discuss the prevention and treatment aspects, concluding with a section on evidence gap and future directions. We focus on adult patients in all stages of cancer therapy from pre-treatment surveillance, to ongoing therapy, and long-term follow up.