Research progress on the effect of anesthesia on anthracycline cardiotoxicity

Hongwei Zhao, Jingcheng Li
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Abstract

Anthracycline-based antitumor drugs are one of the highly effective broad-spectrum anti-cancer drugs that are commonly used clinically. However, anthracyclines have the serious side effect of cumulative dose-related cardiotoxicity. Clinically, intake of myocardial protective drugs is one of the most important strategies for the safe use of anthracyclines in chemotherapy. Numerous cancer patients un- dergoing chemotherapy also require surgery, during which general anesthesia is commonly used. Various studies have shown that propofol and sevoflurane, the most commonly used general anesthetics, present a significant protective effect in myocardial ischemia-reperfusion damage. Therefore, for patients who have just undergone chemotherapy with anthracyclines, anthracycline-induced myocardial injury may occur at the acute or chronic phase of surgery. Consequently, if the effect of anesthetics on the cardiotoxicity of anthracyclines is similar to the protective effect of these drugs for myocardial ischemia-reperfusion damage, this protective effect on cardiotoxicity will have significant impact on the recovery of cardiopulmonary function of patients after surgery. Thus, further studies are needed to establish the effect of anesthetics on the cardiotoxicity of anthracyclines.
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麻醉对蒽环类药物心脏毒性影响的研究进展
蒽环类抗肿瘤药物是临床上常用的高效广谱抗癌药物之一。然而,蒽环类药物具有严重的累积剂量相关的心脏毒性副作用。在临床上,心肌保护药物的摄入是蒽环类药物在化疗中安全使用的重要策略之一。许多接受化疗的癌症患者也需要手术,手术过程中通常使用全身麻醉。各种研究表明,最常用的全身麻醉剂异丙酚和七氟醚对心肌缺血-再灌注损伤具有显著的保护作用。因此,对于刚刚接受蒽环类药物化疗的患者,蒽环类药物引起的心肌损伤可能发生在手术的急性期或慢性期。因此,如果麻醉药对蒽环类药物心脏毒性的作用与蒽环类药物对心肌缺血-再灌注损伤的保护作用相似,那么这种对心脏毒性的保护作用将对术后患者心肺功能的恢复产生显著影响。因此,需要进一步研究麻醉药对蒽环类药物心脏毒性的影响。
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