Echocardiography and biomarkers for the diagnosis of cardiotoxicity
Echocardiography and biomarkers for the diagnosis of cardiotoxicity
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DOI：
10.1007/s00059-020-04957-5
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发表时间：
2020-06-20
期刊：
影响因子：
1.7
通讯作者：
Bauersachs, Johann
中科院分区：
文献类型：
--
作者：
Berliner, Dominik;Beutel, Gernot;Bauersachs, Johann
由于恶性肿瘤的更好的治疗选择，近年来此类疗法的心血管副作用越来越受到关注。肿瘤心脏病学的新心脏病学亚专业正在制定战略，以预防和/或早期发现这些影响，以便及时和充分地治疗它们。心脏毒性作用的诊断主要基于成像和特异性生物标志物。超声心动图已成为主要的成像技术，由于其广泛的可用性。除了使用二维方法定量测定左心室功能外，三维方法在检测心功能不全方面提供了更好的精度和更小的变异性。此外，对整体纵向应变（GLS）的分析揭示了左心室功能的细微变化，从而在左心室射血分数下降之前检测到非常早期的损伤。最近已经测试了各种生物标志物检测心脏毒性的潜力。心肌肌钙蛋白是目前研究最好的生物标志物，当然具有最高的影响。由于相互矛盾的结果，利钠肽的重要性尚未得到最终澄清。髓过氧化物酶的结果是有希望的，循环microRNA的结果也是如此，这些结果仍然主要来自实验数据。在这种情况下，进一步的研究仍然需要显示这些在日常临床实践中的价值。
As a result of better treatment options for malignant cancer, the cardiovascular side effects of such therapies have increasingly come into focus in recent years. The new cardiological subspecialty of oncocardiology is developing strategies to prevent and/or detect those effects early in order to treat them in a timely and adequate manner. The diagnosis of cardiotoxic effects is based mainly on imaging and specific biomarkers. Echocardiography has become the main imaging technique due to its wide availability. In addition to quantitative determination of left ventricular function using two-dimensional methods, three-dimensional methods offer better precision and less variability in the detection of cardiac dysfunction. Furthermore, the analysis of the global longitudinal strain (GLS) reveals even subtle changes in left ventricular function and thus detects very early damage before left ventricular ejection fraction drops. Various biomarkers have been tested recently for their potential to detect cardiotoxicity. Cardiac troponins are currently the best investigated biomarkers and certainly have the highest impact. Due to contradicting results, the importance of natriuretic peptides has not yet been conclusively clarified. Results for myeloperoxidase are promising, as are the results for circulating microRNAs, which still mainly derive from experimental data. In this context, further studies still need to show the value of these in everyday clinical practice.