Pathophysiology and preventive strategies of anthracycline-induced cardiotoxicity.
Pathophysiology and preventive strategies of anthracycline-induced cardiotoxicity.
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DOI：
10.3904/kjim.2016.017
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Youn HJ
中科院分区：
文献类型：
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作者：
Chung WB;Youn HJ
心脏毒性是蒽环类药物治疗后一种众所周知的并发症。然而，它们仍然广泛用于乳腺癌、淋巴瘤、白血病和肉瘤等的化疗。患者的临床特征，如年龄、性别、合并症、蒽环类药物剂量和输注方案以及所使用的联合抗癌药物，在不同癌症类型中是多样的。很难推荐适用于所有癌症类型的蒽环类药物所致心脏毒性的预防或管理指南。因此，蒽环类药物所致心脏毒性仍然是蒽环类药物联合方案治疗癌症患者合理管理的一个主要限制因素。人们已经广泛努力确定蒽环类药物所致心脏毒性的机制和治疗方法。因为心脏毒性会对心肌造成不可逆的损伤，所以预防是比在出现有症状或无症状的心功能障碍后治疗心脏毒性更有效的方法。本文将综述蒽环类药物所致心脏毒性的病理生理机制以及保护心肌免受蒽环类药物损伤的策略。
Cardiotoxicity is a well-known complication following treatment with anthracyclines. However, they are still widely used in chemotherapy for breast cancer, lymphoma, leukemia, and sarcoma, among others. Patient clinical characteristics, such as age, sex, comorbidities, anthracycline dose and infusion schedule, and the combined anti-cancer agents used, are diverse among cancer types. It is difficult to recommend guidelines for the prevention or management of anthracycline-induced cardiotoxicity applicable to all cancer types. Therefore, anthracycline-induced cardiotoxicity remains a major limitation in the proper management of cancer patients treated with an anthracycline-combined regimen. Efforts have been extensive to determine the mechanism and treatment of anthracycline-induced cardiotoxicity. Because cardiotoxicity causes irreversible damage to the myocardium, prevention is a more effective approach than treatment of cardiotoxicity after symptomatic or asymptomatic cardiac dysfunction develops. This article will review the pathophysiological mechanisms of anthracycline-induced cardiotoxicity and strategies for protecting the myocardium from anthracycline.