关于乳腺癌患者和抗癌治疗相关心肌肌钙蛋白升高的管理框架建议

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Michael Cronin , Dina Neiroukh , Aoife Lowery , William Wijns , Michael Kerin , Maccon Keane , Silvie Blazkova , Osama Soliman
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引用次数: 0

摘要

心脏生物标志物是第一版欧洲心脏病学会心脏病肿瘤学指南的重要组成部分。具体来说,它们在轻度无症状癌症治疗相关心功能不全的定义中被提及,即左心室收缩功能≥50%,并伴有两种结果:总体纵向应变比基线下降15%和/或心脏生物标志物上升超过定义的第99百分位数临界值。心肌肌钙蛋白就是这样一种生物标志物。许多乳腺癌治疗方法都有关于心功能障碍和/或心血管毒性的公开数据,这可能会导致心肌肌钙蛋白升高。然而,在抗癌治疗期间如何处理心肌肌钙蛋白升高的问题上,存在着相互矛盾且不完整的数据,这给临床试验环境中的患者护理带来了困惑。其次,关于心肌肌钙蛋白在轻度无症状的 CTRCD 定义中的附加作用的建议引起了激烈的争论。我们建议对生物标志物的作用进行反思,特别是心肌肌钙蛋白。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
Cardiac biomarkers are a vital component within the first edition of the European Society of Cardiology guidelines in Cardio-Oncology. Specifically, they are mentioned in the definition of mild asymptomatic cancer therapy-related cardiac dysfunction, where left ventricular systolic function is ≥50 % with two outcomes; either a new decrease in global longitudinal strain >15 % from baseline and/or a new rise in cardiac biomarkers above the defined 99th percentile cut off values. Cardiac troponin is one such biomarker.
Many of the treatments for breast cancer have published data on cardiac dysfunction and/or cardiovascular toxicity, and such may lead to an elevation in cardiac troponin. However, there is conflicting and incomplete data regarding how to approach an elevated cardiac troponin during anti-cancer treatment, which has confounded patient care in the clinical trial setting.
We propose a novel framework to guide physicians in treatment-related elevation of cardiac troponin in the breast cancer population. Secondly, the additive role which the recommendation that cardiac troponin carries within mild asymptomatic definitions of CTRCD is the subject of great debate. We suggest a reflection on the role of biomarkers, specifically in reference to cardiac troponin.
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来源期刊
IJC Heart and Vasculature
IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
10.30%
发文量
216
审稿时长
56 days
期刊介绍: IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.
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