Кардиоонкология, часть 2. Методы диагностики в кардиоонкологии

Автор: Плохова Е.В., Сорокин А.В., Стаферов А.В., Дундуа Д.П.

Журнал: Клиническая практика @clinpractice

Статья в выпуске: 1 т.9, 2018 года.

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Ранняя диагностика и появление новых методов лечения рака привели к улучшению выживаемости пациентов с онкологическими заболеваниями. Однако, агрессивная терапия, направленная против злокачественного процесса, нередко приводит к новым заболеваниям. К ним, в первую очередь, следует отнести сердечно-сосудистые заболевания (ССЗ). В результате прямого воздействия лучевой терапии и химиотерапии на структуру сердца и сосудов происходит акселерация атеросклероза, поражение кардиомиоцитов и эндотелия, увеличивается склонность к тромбообразованию. Влияние противоопухолевого лечения на сердце разнообразно и наиболее часто определяется как кардиотоксичность. Своевременная диагностика и выявление пациентов с высоким риском кардиотоксичности является первым шагом на пути к успешной профилактике ССЗ у онкобольных, не ставя под угрозу лечение рака, что в конечном итоге приводит к снижению общей смертности. К основным методам диагностики кардиотоксичности до и после лечения относят двухмерную эхокардиографию. Новые методы визуализации - трехмерная эхокардиография, speckle-tracking эхокардиография и магнитно-резонансная томография, показывают еще более высокую чувствительность при выявлении ранних изменений функции миокарда на фоне проводимой терапии рака. В данной статье рассматриваются основные диагностические алгоритмы и подходы, применяемые в кардиоонкологии.

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Кардиотоксичность, дисфункция левого желудочка, сердечная недостаточность, эхокардиография, speckle-tracking эхокардиография

Короткий адрес: https://sciup.org/143166531

IDR: 143166531 | DOI: 10.17816/clinpract09150-62

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