心脏瘤学中的药物预防:从长椅到床边
Ashot A Avagimyan1, Nana Pogosova2,3, Federica Fogacci4
1Department of Internal Diseases Propedeutics, Yerevan State Medical University, Yerevan, 0025, Armenia. ashot.avagimyan@meduni.am.
Heart failure reviews
|December 1, 2025
概括
癌症疗法,如人环素可以伤害心脏 (与癌症治疗相关的心血管毒性). 本综述探讨了预防这种心脏损伤的方法,强调了新的潜在治疗方法,如SGLT2抑制剂.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学 是一个学科.
背景情况:
- 癌症存活率有所改善,但像 antracyclines 这样的治疗方法会导致显著的心血管风险,称为癌症治疗相关心血管毒性 (CTR-CVT).
- 缓解CTR-CVT对于维持患者的生活质量和治疗坚持至关重要.
研究的目的:
- 审查和整合关于预防和管理CTR-CVT的策略的证据,特别是与antracycline化疗相关的策略.
- 评估各种药理干预措施在癌症治疗期间保持心血管功能的有效性.
主要方法:
- 对针对CTR-CVT的心脏保护策略的临床前和临床研究进行系统审查.
- 从研究神经激素抑制剂,阿尔多激素对抗剂,他类药物和SGLT2抑制剂的试验中分析数据.
主要成果:
- 神经激素抑制剂 (ACEi,ARBs,βB) 是基本的,但结果各不相同; 卡维迪洛尔提供抗氧化功效. 萨库比特里尔/瓦尔萨坦 (ARNI) 在保持LVEF方面表现有前途,但具有低血压风险.
- 阿尔多斯特对抗剂,如螺旋乳,可以保持LVEF和透缩功能. 类固醇药的有效性是相互矛盾的,一些试验显示有好处,而另一些则没有.
- 新出现的数据表明,-葡萄糖共运输体-2 抑制剂 (SGLT2i) 通过代谢调节,抗炎和抗氧化作用提供心脏保护.
结论:
- 在了解CTR-CVT病理生理学和风险分层方面存在重大差距.
- 未来的研究应该专注于个性化医疗,动态风险评估,并探索心脏代谢功能障碍.
- SGLT2 抑制剂是预防CTR-CVT的一个有希望的前沿,需要在临床试验中进一步验证.
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