Jacc: Cardiooncology最新文献_第6页

Cancer Therapy and Exercise Intolerance: The Heart Is But a Part 癌症治疗与运动不耐受：心脏只是一部分

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.04.006

{"title":"Cancer Therapy and Exercise Intolerance: The Heart Is But a Part","authors":"","doi":"10.1016/j.jaccao.2024.04.006","DOIUrl":"10.1016/j.jaccao.2024.04.006","url":null,"abstract":"<div><p>The landscape of cancer therapeutics is continually evolving, with successes in improved survivorship and reduced disease progression for many patients with cancer. Improved cancer outcomes expose competing comorbidities, some of which may be exacerbated by cancer therapies. The leading cause of disability and death for many early-stage cancers is cardiovascular disease (CVD), which is often attributed to direct or indirect cardiac injury from cancer therapy. In this review, the authors propose that toxicities related to conventional and novel cancer therapeutics should be considered beyond the heart. The authors provide a framework using the oxygen pathway to understand the impact of cancer treatment on peak oxygen uptake, a marker of integrative cardiopulmonary function and CVD risk. Peripheral toxicities and the impact on oxygen transport are discussed. Consideration for the broad effects of cancer therapies will improve the prediction and identification of cancer survivors at risk for CVD, functional disability, and premature mortality and those who would benefit from therapeutic intervention, ultimately improving patient outcomes.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 4","pages":"Pages 496-513"},"PeriodicalIF":12.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001510/pdfft?md5=ef3ce0717a05b360787f0aae64a19422&pid=1-s2.0-S2666087324001510-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Echocardiography-Guided Radiofrequency Ablation for Cardiac Tumors 超声心动图引导下的心脏肿瘤射频消融术

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.03.008

Junzhe Huang MS , Changhui Lei MBBS , David H. Hsi MD , Minjuan Zheng MD, PhD , Hui Ma MBBS , Shengjun Ta MBBS , Rui Hu MS , Chao Han MD, PhD , Wenxia Li MBBS , Jing Li MBBS , Dong Qu MBBS , Fangqi Ruan PhD , Jing Wang MD, PhD , Bo Wang MBBS , Xueli Zhao MBBS , Jiao Liu PhD , Lina Zhao MD, PhD , Zhe Wang MD, PhD , Jian Yang MD, PhD , Liwen Liu MD, PhD

{"title":"Echocardiography-Guided Radiofrequency Ablation for Cardiac Tumors","authors":"Junzhe Huang MS , Changhui Lei MBBS , David H. Hsi MD , Minjuan Zheng MD, PhD , Hui Ma MBBS , Shengjun Ta MBBS , Rui Hu MS , Chao Han MD, PhD , Wenxia Li MBBS , Jing Li MBBS , Dong Qu MBBS , Fangqi Ruan PhD , Jing Wang MD, PhD , Bo Wang MBBS , Xueli Zhao MBBS , Jiao Liu PhD , Lina Zhao MD, PhD , Zhe Wang MD, PhD , Jian Yang MD, PhD , Liwen Liu MD, PhD","doi":"10.1016/j.jaccao.2024.03.008","DOIUrl":"10.1016/j.jaccao.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Patients with cardiac tumors may present challenges for surgical resection due to poor clinical condition. Echocardiography-guided transapical radiofrequency ablation for cardiac tumors (TARFACT) potentially offers a less invasive palliative therapy option.</p></div><div><h3>Objectives</h3><p>This study aimed to evaluate the safety and efficacy of TARFACT.</p></div><div><h3>Methods</h3><p>Five patients with cardiac tumors (mucinous liposarcoma, myocardial hypertrophy with inflammatory cell infiltration mass, fibrous tissue tumor hyperplasia, myocardial clear cell sarcoma, and cardiac rhabdomyoma) were included. All patients underwent TARFACT and were assessed with electrocardiogram, echocardiographic imaging, biochemical analysis, and pathological confirmation.</p></div><div><h3>Results</h3><p>The median follow-up for all patients was 9 (range 4-12) months. Three surviving patients were alive at their last follow-up (9, 12, and 12 months, respectively), whereas 2 patients with late-stage tumors survived 6 months and 13 months after TARFACT, respectively. After TARFACT, all patients showed significant reductions in tumor size: the mean length decreased from 6.7 ± 2.0 cm to 4.7 ± 1.8 cm (<em>P</em> = 0.007); and the mean width decreased from 5.0 ± 2.1 cm to 2.5 ± 0.7 cm (<em>P</em> = 0.041). NYHA functional class also improved: median (IQR) decreased from 3.0 (1.5) to 2.0 (1.0) (<em>P</em> = 0.038), Peak E-wave on echocardiography showed a mean increase from 64.4 ± 15.7 cm/s to 76.6 ± 18.6 cm/s (<em>P</em> = 0.008), and NT-pro BNP levels had a median (IQR) reduction from 115.7 (252.1) pg/mL to 55.0 (121.6) pg/mL (<em>P</em> = 0.043).</p></div><div><h3>Conclusions</h3><p>TARFACT is a novel palliative treatment option for cardiac tumors, reducing accessible tumors and improving clinical symptoms in a preliminary group of patients. (Cardiac Tumors Interventional [Radio Frequency/Laser Ablation] Therapy [CTIH]; <span><span>NCT02815553</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 4","pages":"Pages 560-571"},"PeriodicalIF":12.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001406/pdfft?md5=d5e348eb1c82c9980ac1986cd5c8798a&pid=1-s2.0-S2666087324001406-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep Inspiration Breath Hold for Cardiac Sparing 深吸气屏气，以达到心脏疏导的目的

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.06.003

Fleure Gallant MDCM , Reshma Jagsi MD, DPhil

引用次数: 0

Association of Cardiac Substructure Radiation Dose With Arrhythmia 心脏亚结构辐射剂量与心律失常的关系

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.07.007

Gerard Walls MB, BCH, PhD , Alan McWilliam PhD

引用次数: 0

Probing the Anthracycline-Induced Myocardial Injury 探究蒽环类药物诱发的心肌损伤

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.04.008

Claudius Statescu MD, Manel El Blidi-Rahmani MD

引用次数: 0

Cardiac Tumors and Innovations in Local Therapies 心脏肿瘤与局部疗法的创新

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.04.001

Timothy M. Markman MD , John P. Plastaras MD, PhD

引用次数: 0

Clonal Hematopoiesis Is Associated With Cardiomyopathy During Solid Tumor Therapy 克隆性造血与实体瘤治疗期间的心肌病有关

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.05.013

Etienne Leveille MD, Rachel Jaber Cheheyeb BS, Carlos Matute-Martinez MD, Nathan W. Chen BA, Ritujith Jayakrishnan MD, Anthos Christofides MD, Derrick Lin MD, Yunju Im PhD, Giulia Biancon PhD, Jennifer VanOudenhove PhD, Stephanie Halene MD, PhD, Jennifer M. Kwan MD, PhD

引用次数: 0

Optimizing Cardiovascular Risk Prediction From CT Imaging at the Radiation Oncology Point of Care 在放射肿瘤学治疗点通过 CT 成像优化心血管风险预测

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.07.003

Katelyn M. Atkins MD, PhD , Andriana P. Nikolova MD, PhD

引用次数: 0

Predictive Performance of Cardiovascular Risk Scores in Cancer Survivors From the UK Biobank 英国生物库癌症幸存者心血管风险评分的预测性能

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.05.015

Celeste McCracken MSc , Dorina-Gabriela Condurache MBBS , Liliana Szabo MBBS, PhD , Hussein Elghazaly MBBS , Fiona M. Walter MA, MD , Adam J. Mead MBBS, PhD , Ronjon Chakraverty MBBS, PhD , Nicholas C. Harvey MB BChir, PhD , Charlotte H. Manisty MBBS, PhD , Steffen E. Petersen MSc, MPH, MD, DPhil , Stefan Neubauer MBBS , Zahra Raisi-Estabragh MBChB, PhD

{"title":"Predictive Performance of Cardiovascular Risk Scores in Cancer Survivors From the UK Biobank","authors":"Celeste McCracken MSc , Dorina-Gabriela Condurache MBBS , Liliana Szabo MBBS, PhD , Hussein Elghazaly MBBS , Fiona M. Walter MA, MD , Adam J. Mead MBBS, PhD , Ronjon Chakraverty MBBS, PhD , Nicholas C. Harvey MB BChir, PhD , Charlotte H. Manisty MBBS, PhD , Steffen E. Petersen MSc, MPH, MD, DPhil , Stefan Neubauer MBBS , Zahra Raisi-Estabragh MBChB, PhD","doi":"10.1016/j.jaccao.2024.05.015","DOIUrl":"10.1016/j.jaccao.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular preventive strategies are guided by risk scores with unknown validity in cancer cohorts.</p></div><div><h3>Objectives</h3><p>This study aimed to evaluate the predictive performance of 7 established cardiovascular risk scores in cancer survivors from the UK Biobank.</p></div><div><h3>Methods</h3><p>The predictive performance of QRISK3, Systematic Coronary Risk Evaluation 2 (SCORE2)/Systematic Coronary Risk Evaluation for Older Persons (SCORE-OP), Framingham Risk Score, Pooled Cohort equations to Prevent Heart Failure (PCP-HF), CHARGE-AF, QStroke, and CHA<sub>2</sub>DS<sub>2</sub>-VASc was calculated in participants with and without a history of cancer. Participants were propensity matched on age, sex, deprivation, health behaviors, family history, and metabolic conditions. Analyses were stratified into any cancer, breast, lung, prostate, brain/central nervous system, hematologic malignancies, Hodgkin lymphoma, and non-Hodgkin lymphoma. Incident cardiovascular events were tracked through health record linkage over 10 years of follow-up. The area under the receiver operating curve, balanced accuracy, and sensitivity were reported.</p></div><div><h3>Results</h3><p>The analysis included 31,534 cancer survivors and 126,136 covariate-matched controls. Risk score distributions were near identical in cases and controls. Participants with any cancer had a significantly higher incidence of all cardiovascular outcomes than matched controls. Performance metrics were significantly worse for all risk scores in cancer cases than in matched controls. The most notable differences were among participants with a history of hematologic malignancies who had significantly higher outcome rates and poorer risk score performance than their matched controls. The performance of risk scores for predicting stroke in participants with brain/central nervous system cancer was very poor, with predictive accuracy more than 30% lower than noncancer controls.</p></div><div><h3>Conclusions</h3><p>Existing cardiovascular risk scores have significantly worse predictive accuracy in cancer survivors compared with noncancer comparators, leading to an underestimation of risk in this cohort.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 4","pages":"Pages 575-588"},"PeriodicalIF":12.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324002151/pdfft?md5=a3698cdfec1ed81262f719f95426233e&pid=1-s2.0-S2666087324002151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Baseline Cardiac Parameters as Biomarkers of Radiation Cardiotoxicity in Lung Cancer 作为肺癌放射性心脏毒性生物标志物的基线心脏参数

IF 12 1区医学

Jacc: Cardiooncology Pub Date : 2024-08-01 DOI: 10.1016/j.jaccao.2024.05.009

Gerard M. Walls MB BCh, PhD , Nicola Hill MB BCh , Michael McMahon MB BCh , Brian óg Kearney MB BCh , Conor McCann MB BCh , Peter McKavanagh MB BCh, PhD , Valentina Giacometti PhD , Aidan J. Cole MB BCh, PhD , Suneil Jain MB BCh, PhD , Conor K. McGarry PhD , Karl Butterworth PhD , Jonathan McAleese MB BCh, MA , Mark Harbinson MB BCh, MD , Gerard G. Hanna MB BCh, PhD

{"title":"Baseline Cardiac Parameters as Biomarkers of Radiation Cardiotoxicity in Lung Cancer","authors":"Gerard M. Walls MB BCh, PhD , Nicola Hill MB BCh , Michael McMahon MB BCh , Brian óg Kearney MB BCh , Conor McCann MB BCh , Peter McKavanagh MB BCh, PhD , Valentina Giacometti PhD , Aidan J. Cole MB BCh, PhD , Suneil Jain MB BCh, PhD , Conor K. McGarry PhD , Karl Butterworth PhD , Jonathan McAleese MB BCh, MA , Mark Harbinson MB BCh, MD , Gerard G. Hanna MB BCh, PhD","doi":"10.1016/j.jaccao.2024.05.009","DOIUrl":"10.1016/j.jaccao.2024.05.009","url":null,"abstract":"<div><h3>Background</h3><p>Radiation-induced cardiotoxicity poses a significant challenge in lung cancer management because of the close anatomical proximity of the heart to the lungs, compounded by a high prevalence of cardiovascular risk factors among patients.</p></div><div><h3>Objectives</h3><p>The aim of this study was to assess the predictive value of routinely available clinical and imaging-based cardiac parameters in identifying “high risk” patients for major adverse cardiac events (MACE) and mortality following radiation therapy (RT).</p></div><div><h3>Methods</h3><p>The medical records of patients who underwent definitive RT for non–small cell lung cancer using modern planning techniques at a single center between 2015 and 2020 were retrospectively reviewed. Cardiac events were verified by cardiologists, and mortality data were confirmed with the national registry. Cardiac substructures were autosegmented on RT planning scans for retrospective structure and dose analysis, and their correlation with clinical factors was examined. Fine-Gray models were used to analyze relationships while considering the competing risk for death.</p></div><div><h3>Results</h3><p>Among 478 patients included in the study, 77 (16%) developed 88 MACE, with a median time to event of 16.3 months. A higher burden of pre-existing cardiac diseases was associated with an increased cumulative incidence of MACE (55% [95% CI: 12%-20%] vs 16% [95% CI: 35%-71%]; <em>P</em> < 0.001). Left atrial and left ventricular enlargement on RT planning scans was associated with cumulative incidence of atrial arrhythmia (14% [95% CI: 9%-20%] vs 4% [95% CI: 2%-8%]; <em>P</em> = 0.001) and heart failure (13% [95% CI: 8%-18%] vs 6% [95% CI: 3%-10%]; <em>P</em> = 0.007) at 5 years, respectively. However, myocardial infarction was not associated with the presence of coronary calcium (4.2% [95% CI: 2%-7%] vs 0% [95% CI: 0%-0%]; <em>P</em> = 0.094). No cardiac imaging metrics were found to be both clinically and statistically associated with survival.</p></div><div><h3>Conclusions</h3><p>The present findings suggest that cardiac history and RT planning scan parameters may offer potential utility in prospectively evaluating cardiotoxicity risk following RT for patients with lung cancer.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 4","pages":"Pages 529-540"},"PeriodicalIF":12.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001972/pdfft?md5=2cfea7dc836ba7f66911832f2566e9bf&pid=1-s2.0-S2666087324001972-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0