心脏保护策略的进展:通过新的生物标志物和药理学方法关注乳腺癌及其他癌症。

European cardiology Pub Date : 2025-09-09 eCollection Date: 2025-01-01 DOI:10.15420/ecr.2025.26
Giulia Tamburrini, Celia de Cobos García, Teresa López-Fernández
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引用次数: 0

摘要

最近癌症治疗的进步显著提高了患者的存活率,这引起了人们对使用肿瘤治疗后可能出现的心血管并发症的关注。这些并发症可严重影响生活质量和长期预后,有时导致需要修改或停止癌症治疗。这凸显了迫切需要有效的心脏保护策略来预防和减轻临床和亚临床心脏毒性,以及减少急性和慢性心脏损伤。在这篇综述中,我们批判性地评估了临床实践中用于早期检测和监测心脏毒性的心脏生物标志物,重点关注n端前b型利钠肽和肌钙蛋白,因为它们具有既定的预测价值。我们还探索了可能改善癌症患者心血管风险评估的新兴生物标志物。在药理学方面,β受体阻滞剂、血管紧张素转换酶抑制剂和钠-葡萄糖共转运蛋白2抑制剂显示出减轻心脏毒性的潜力,尽管随机试验的证据仍然好坏参半。非药物方法也进行了讨论,目的是将综合心血管预防纳入肿瘤护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advances in Cardioprotection Strategies: Focusing on Breast Cancer and Beyond Through Novel Biomarkers and Pharmacological Approaches.

Recent improvements in cancer treatments have significantly improved patient survival rates, which has drawn attention to cardiovascular complications that may arise after using oncological therapies. These complications can seriously affect quality of life and long-term outcomes, sometimes leading to the need for modification or discontinuation of cancer treatment. This highlights the urgent need for effective cardioprotective strategies to prevent and mitigate clinical and subclinical cardiotoxicity, as well as reducing acute and chronic cardiac damage. In this review, we critically evaluate the cardiac biomarkers used in clinical practice for early detection and monitoring of cardiotoxicity, focusing on N-terminal pro-B-type natriuretic peptide and troponins due to their established predictive value. We also explore emerging biomarkers that may improve cardiovascular risk assessment in cancer patients. On the pharmacological front, β-blockers, angiotensin-converting enzyme inhibitors and sodium-glucose cotransporter 2 inhibitors show potential for mitigating cardiotoxicity, although evidence from randomised trials remains mixed. Non-pharmacological approaches are also discussed, and the aim is to integrate comprehensive cardiovascular prevention into oncology care.

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