肿瘤学综述:药物引起的心脏毒性。

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Nilima Rajpal Kundnani, Vincenzo Passini, Iulia Stefania Carlogea, Patrick Dumitrescu, Vlad Meche, Roxana Buzas, Daniel Marius Duda-Seiman
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引用次数: 0

摘要

癌症药物可能导致心脏问题,由于并发症的风险,这在肿瘤患者中很难治疗。在某些情况下,这可能会严重影响他们的健康和治疗结果。总的来说,这些并发症属于“药物性心脏毒性”,主要是由于化疗药物对心脏具有特异性毒性,导致心脏有效泵血能力下降,导致左心室射血分数(LVEF)降低,随后可能导致心力衰竭。蒽环类药物、烷基化剂和针对癌症的靶向治疗都有可能对心脏造成有害影响。心脏相关问题的发生率因患者而异,并取决于多种因素,包括药物类型、剂量、治疗持续时间和先前存在的心脏病。肿瘤药物致心血管损害的潜在机制相当复杂。有一类特殊的药物,被称为蒽环类药物,因其对氧化应激的影响和对心肌细胞造成直接伤害的能力而引起了人们的关注。活性氧(ROS)通过诱导心脏细胞损伤和程序性细胞死亡而造成危害。传统的生物标志物只能表明已经发生的一定程度的损害,因此早期检测是关键。正在开发诸如基因谱分析之类的新方法,以便在出现临床症状之前检测有风险的个体。关键的管理策略——包括早期检测、个性化医疗方法和新型生物标志物的使用——在减轻心脏毒性和改善患者预后方面发挥着至关重要的作用。识别产生的基因改变及其与心脏毒性可能性增加的关联,将允许采用更个性化的方法进行治疗,旨在降低心脏事件的发生率,同时保持较高的肿瘤疗效。肿瘤药物引起的心脏毒性是通过结合心脏和肿瘤知识的预防策略和治疗干预相结合来管理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Overview of Oncology: Drug-Induced Cardiac Toxicity.

Cancer medications can cause cardiac issues, which are difficult to treat in oncologic patients because of the risk of complications. In some cases, this may significantly impact their well-being and treatment outcomes. Overall, these complications fall under the term "drug induced cardiotoxicity", mainly due to chemotherapy drugs being specifically toxic to the heart, causing a decrease in the heart's capacity to pump blood efficiently and leading to a reduction in the left ventricular ejection fraction (LVEF), and subsequently possibly leading to heart failure. Anthracyclines, alkylating agents, and targeted therapies for cancer hold the potential of causing harmful effects on the heart. The incidence of heart-related issues varies from patient to patient and depends on multiple factors, including the type of medication, dosage, duration of the treatment, and pre-existing heart conditions. The underlying mechanism leading to oncologic-drug-induced cardiovascular harmful effects is quite complex. One particular group of drugs, called anthracyclines, have garnered attention due to their impact on oxidative stress and their ability to cause direct harm to heart muscle cells. Reactive oxygen species (ROS) cause harm by inducing damage and programmed cell death in heart cells. Conventional biomarkers alone can only indicate some degree of damage that has already occurred and, therefore, early detection is key. Novel methods like genetic profiling are being developed to detect individuals at risk, prior to the onset of clinical symptoms. Key management strategies-including early detection, personalized medicine approaches, and the use of novel biomarkers-play a crucial role in mitigating cardiotoxicity and improving patient outcomes. Identification of generated genetic alterations and the association to an increased likelihood of cardiotoxicity will allow treatment in a more personalized approach, aiming at decreasing rates of cardiac events while maintaining high oncological efficacy. Oncology drug-induced cardiotoxicity is managed through a combination of preventive strategies and therapeutic interventions from the union of cardiac and oncological knowledge.

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来源期刊
Medicina-Lithuania
Medicina-Lithuania 医学-医学:内科
CiteScore
3.30
自引率
3.80%
发文量
1578
审稿时长
25.04 days
期刊介绍: The journal’s main focus is on reviews as well as clinical and experimental investigations. The journal aims to advance knowledge related to problems in medicine in developing countries as well as developed economies, to disseminate research on global health, and to promote and foster prevention and treatment of diseases worldwide. MEDICINA publications cater to clinicians, diagnosticians and researchers, and serve as a forum to discuss the current status of health-related matters and their impact on a global and local scale.
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