Use of Echocardiography to Evaluate the Cardiac Effects of Therapies Used in Cancer Treatment: What Do We Know?

被引:38
作者
Oreto, Lilia [2 ]
Todaro, Maria Chiara [2 ]
Umland, Matt M. [1 ]
Kramer, Christopher [1 ]
Qamar, Rubina [3 ]
Carerj, Scipione [2 ]
Khandheria, Bijoy K. [1 ]
Paterick, Timothy E. [1 ]
机构
[1] Univ Wisconsin, Sch Med & Publ Hlth, Aurora Sinai Aurora St Lukes Med Ctr, Aurora Cardiovasc Serv, Milwaukee, WI 53215 USA
[2] Univ Messina, Clin & Expt Dept Med & Pharmacol, Messina, Italy
[3] Aurora Adv Healthcare, Milwaukee, WI USA
关键词
Chemotherapy; Cardiotoxicity; Echocardiography; Longitudinal strain; Diastolic and systolic function; TRASTUZUMAB-INDUCED CARDIOTOXICITY; LEFT-VENTRICULAR DYSFUNCTION; TIME 3-DIMENSIONAL ECHOCARDIOGRAPHY; CONGESTIVE-HEART-FAILURE; ANTHRACYCLINE CARDIOTOXICITY; DOPPLER-ECHOCARDIOGRAPHY; MYOCARDIAL DYSFUNCTION; EJECTION FRACTION; TROPONIN-I; DOXORUBICIN;
D O I
10.1016/j.echo.2012.09.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiologists and oncologists today face the daunting challenge of identifying patients at risk for late-onset left ventricular (LV) systolic dysfunction from the use of various chemotherapeutic agents. Currently, the most widely used method in clinical practice for monitoring the potential of chemotherapy-induced cardiotoxicity is calculation of LV ejection fraction. The use of LV ejection fraction to determine whether to continue or discontinue the use of chemotherapeutic agents is limited, because decreases in LV ejection fraction frequently occur late and can be irreversible. These limitations have led to the exploration of diastolic function and newer modalities that assess myocardial mechanics to identify sensitive and specific variables that can predict the occurrence of late systolic function. The cancer therapies associated with cardiotoxicity are reviewed in this report. Additionally, the authors evaluate the role of present-day echocardiographic parameters, complementary noninvasive imaging modalities, and biomarkers in the prediction of cardiotoxicity. The authors address the evolving role of cardioprotective agents and potential therapies to prevent or reverse the progression of LV systolic dysfunction. Finally, they provide some ideas regarding future directions to enhance the knowledge of predicting late-onset LV systolic dysfunction secondary to cancer therapy. (J Am Soc Echocardiogr 2012;25:1141-52.)
引用
收藏
页码:1141 / 1152
页数:12
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