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アントラサイクリンによる心臓毒性の早期発見と,心不全治療による改善
Daniela Cardinale1, Alessandro Colombo2, Giulia Bacchiani2
1From European Institute of Oncology, Milan, Italy (D.C., A.C., G.B., I.T., C.A.M., M.C., G.L., N.C., G.C., C.M.C.); and Centro Cardiologico Monzino (I.R.C.C.S.), Milan, Italy (F.V., C.F.). daniela.cardinale@ieo.it.
Circulation
|May 8, 2015
まとめ
アントラサイクリン誘発の心臓毒性は,治療の1年以内にしばしば発生します. 早期発見と心不全治療は,心臓機能の回復の鍵であり,特に累積投与量が高い場合です.
科学分野:
- 心臓病学 心臓病学
- 腫瘍学 腫瘍学
- 薬理学 薬理学とは
背景:
- アントラサイクリン化学療法は心臓毒性を引き起こす可能性があり,現在の分類には強力な支持データがない.
- アントラサイクリン誘発の心臓毒性の発生率,タイミング,および臨床的要因を理解するために,将来的な評価が必要です.
研究 の 目的:
- アントラサイクリン誘発性心臓毒性の発生率,タイミング,臨床相関値,治療応答を将来的に評価する.
- 心臓毒性の発症と回復に影響を与える要因を調査する.
主な方法:
- アントラサイクリンを投与した2625人の患者で,左心室射出分数 (LVEF) を評価した.
- 化学療法中のおよび後のLVEFのモニタリング,心臓毒性に対する心不全治療の開始.
- 定義され,追跡された心臓毒性からの回復.
主要な成果:
- 総合的な心毒性発症率は9%で,化学療法後の平均発症期間は3.5ヶ月で,98%は最初の1年以内に発生しました.
- 心臓機能の完全または部分的な回復は,罹患患者の82%で観察されました.
- 終末化学療法のLVEFと累積ドクソルビシン用量は,心臓毒性の独立した予測因子でした.
結論:
- アントラサイクリン誘発の心臓毒性は,主に治療後1年以内に発現します.
- 心臓毒性は,累積的なアントラサイクリン用量と,治療終了時のLVEFに関連しています.
- 早期発見と迅速な心不全管理は,重要な心機能回復に不可欠です.
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