化疗所致心脏毒性治疗中的心脏保护策略:当前方法和未来方向。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL Annals of Medicine and Surgery Pub Date : 2024-10-16 eCollection Date: 2024-12-01 DOI:10.1097/MS9.0000000000002668
Zeineb Al-Hasnawi, Hawraa Mohammed Hasan, Jaafar Mohammed Abdul Azeez, Naam Kadhim, Aya Ahmed Shimal, Maryam Hussein Sadeq, Noor Al-Huda Ali Motashar Mahood, Abdulmelik A N Al-Qara Ghuli, Ahmed Safaa Hussein, Priyadarshi Prajjwal, Hritvik Jain, Aman Goyal, Omniat Amir
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引用次数: 0

摘要

背景:化疗诱导的心脏毒性(CIC)是癌症治疗中的一个重大挑战,可导致心力衰竭和心肌梗死。随着癌症存活率的上升,幸存者的长期心血管健康变得越来越重要。虽然已经研究了几种心脏保护药物来减轻化疗对心脏的有害影响,但需要更多的研究来证实它们的有效性和最佳使用方法。方法:本综述综合了心血管保护药物治疗CIC的证据。作者对2000年1月至2024年5月间发表的同行评审文章、临床试验和荟萃分析进行了全面的文献检索。研究的选择基于相关性、质量以及对心脏保护剂(如-受体阻滞剂、ACE抑制剂、arb、他汀类药物和右拉唑烷)的机制、疗效和临床结果的关注。结果和讨论:心脏保护药物显示出减轻化疗对心功能影响的潜力。-受体阻滞剂和ACE抑制剂可有效降低心力衰竭发生率并改善心脏预后。具有抗炎和抗氧化特性的他汀类药物和减少蒽环类药物引起的心脏毒性的右唑嗪也显示出希望。然而,研究设计、患者群体和化疗方法的可变性使标准化治疗方案的建立复杂化。结论:心脏保护药物在控制CIC和改善癌症患者心脏预后方面具有重要的前景。目前的证据支持-受体阻滞剂、ACE抑制剂、他汀类药物和右拉唑烷的疗效。需要进一步的研究来建立标准化的方案,评估长期安全性,优化治疗时机。将心脏保护策略纳入肿瘤护理可以提高癌症幸存者的生活质量和预后。
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Cardioprotective strategies in the management of chemotherapy-induced cardiotoxicity: current approaches and future directions.

Background: Chemotherapy-induced cardiotoxicity (CIC) is a significant challenge in cancer treatment, leading to heart failure and myocardial infarction. With rising cancer survival rates, the long-term cardiovascular health of survivors has gained importance. While several cardioprotective medications have been studied to mitigate chemotherapy's harmful effects on the heart, more research is needed to confirm their effectiveness and optimal use.

Methodology: This review synthesizes evidence on cardioprotective drugs in managing CIC. The authors conducted a comprehensive literature search of peer-reviewed articles, clinical trials, and meta-analyses published between January 2000 and May 2024. Studies were selected based on relevance, quality, and focus on mechanisms, efficacy, and clinical outcomes of cardioprotective agents such as beta-blockers, ACE inhibitors, ARBs, statins, and dexrazoxane.

Results and discussion: Cardioprotective medications show potential in alleviating the impact of chemotherapy on heart function. Beta-blockers and ACE inhibitors effectively reduce heart failure incidence and improve cardiac outcomes. Statins, with their anti-inflammatory and antioxidative properties, and dexrazoxane, which reduces anthracycline-induced cardiotoxicity, also show promise. However, variability in study designs, patient groups, and chemotherapy treatments complicates the establishment of standardized treatment protocols.

Conclusion: Cardioprotective drugs hold significant promise in managing CIC and improving cardiac outcomes for cancer patients. Current evidence supports the efficacy of beta-blockers, ACE inhibitors, statins, and dexrazoxane. Further research is needed to establish standardized protocols, evaluate long-term safety, and optimize treatment timing. Integrating cardioprotective strategies into oncological care can enhance the quality of life and prognosis for cancer survivors.

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Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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1665
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