癌症治疗相关的心脏功能障碍在患有前列腺癌的患者中,这些患者正在接受抗雄激素缺乏治疗
Dong-Yi Chen1,2, Cheng-Hung Lee1,2, Ming-Lung Tsai3,2
1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou Chang Gung University College of Medicine Taoyuan Taiwan.
Journal of the American Heart Association
|September 26, 2023
概括
前列腺癌的雄激素剥夺疗法 (ADT) 增加了心脏功能障碍的风险. 较低的基线左心室喷射分数 (LVEF) 预测了这种风险,强调了在ADT期间需要进行心脏监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 雄激素剥夺疗法 (ADT) 是前列腺癌的标准治疗方法.
- 与ADT相关的心脏功能障碍的真实风险尚未得到充分证实.
- 心脏功能障碍可以显著影响患者的结果和生活质量.
研究的目的:
- 在接受ADT的前列腺癌患者中调查与癌症治疗相关的心脏功能障碍 (CT-RCD) 的发生率和预测因素.
- 评估基线左心室喷射分数 (LVEF) 和CT-RCD的发展之间的关联.
- 为了评估CT-RCD在不同ADT模式中的风险.
主要方法:
- 来自长光研究数据库 (2001-2019) 的1120名前列腺癌患者的回顾性分析.
- 在ADT之前和期间 (GnRH激动剂,GnRH抗剂或骨科切除术) 评估421名患者的LVEF变化.
- 从基线来看,CT-RCD的定义是LVEF绝对下降≥10%至<53%.
主要成果:
- 在1.6年内,ADT与LVEF的平均下降率从66.3%降至62.5%有关.
- CT-RCD发生在13.7%的患者中 (58/421),LVEF的最低点为40.3%.
- 较低的基线LVEF (截止值64.5%) 是CT-RCD (OR1.07,AUC75.6%) 的显著预测指标.
结论:
- ADT,包括GnRH激动剂,GnRH抗剂和管切除术,在前列腺癌患者中增加CT-RCD的风险.
- 基线LVEF是识别患有ADT诱导心脏功能障碍风险较高的患者的关键预测指标.
- 积极的心脏监测和风险分层对于接受前列腺癌ADT的患者至关重要.
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