Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group.
Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group.
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DOI：
10.1016/s1470-2045(14)70409-7
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发表时间：
2015-03
期刊：
影响因子：
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通讯作者：
International Late Effects of Childhood Cancer Guideline Harmonization Group
中科院分区：
文献类型：
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作者：
Armenian SH;Hudson MM;Mulder RL;Chen MH;Constine LS;Dwyer M;Nathan PC;Tissing WJ;Shankar S;Sieswerda E;Skinner R;Steinberger J;van Dalen EC;van der Pal H;Wallace WH;Levitt G;Kremer LC;International Late Effects of Childhood Cancer Guideline Harmonization Group
接受蒽环类药物化疗或胸部放疗的儿童癌症幸存者发生充血性心力衰竭（CHF）的风险增加。在该人群中，CHF被公认为是一种进行性疾病，在体征和症状之前存在可变的无症状心肌病时期。因此，已经制定了一些实践指南，以促进无症状心肌病的检测和治疗。这些指南在风险人群的定义、监测方式和频率以及干预建议方面有所不同。这些差异可能妨碍这些建议的有效执行。我们报告了一项国际合作的结果，该合作旨在协调现有的心肌病监测建议，采用基于证据的方法，该方法依赖于感兴趣结果的标准化定义和证据质量的透明呈现。根据证据的质量和早期发现和干预的潜在益处，对由此产生的建议进行了分级。
Childhood cancer survivors treated with anthracycline chemotherapy or chest radiation are at an increased risk of developing congestive heart failure (CHF). In this population, CHF is well-recognized as a progressive disorder, with a variable period of asymptomatic cardiomyopathy which precedes signs and symptoms. As a result, a number of practice guidelines have been developed to facilitate detection and treatment of asymptomatic cardiomyopathy. These guidelines differ with regards to definitions of at risk populations, surveillance modality and frequency, and recommendations for interventions. These differences may hinder the effective implementation of these recommendations. We report on the results of an international collaboration to harmonize existing cardiomyopathy surveillance recommendations, using an evidence-based approach that relied on standardized definitions for outcomes of interest and transparent presentation of the quality of the evidence. The resultant recommendations were graded according to the quality of the evidence and the potential benefit gained from early detection and intervention.