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抗肿瘤治疗引起的心血管并发症逐渐成为肿瘤患者死亡的重要原因。校正的QT(QTc)间期延长及室性心律失常是抗肿瘤治疗的心血管毒性之一,室性心律失常往往预示着复杂的临床病程。抗肿瘤药物通过阻断快速延迟整流钾通道和/或缓慢激活延迟整流钾通道等多种机制致QTc间期延长,并在多种危险因素的作用下诱导室性心律失常发生。借助T波形态、微伏T波电交替、心脏电生理平衡指数等心电学指标,Tisdale风险评分计算器、QT间期的多基因风险评分和QTNet模型等多种评分系统,以及全基因组关联研究和药物基因组学等可对QTc间期延长及室性心律失常进行早期风险识别和干预,有助于改善患者预后。
Abstract:[1] HERRMANN J, LENIHAN D, ARMENIAN S, et al.Defining cardiovascular toxicities of cancer therapies:an International Cardio-Oncology Society(IC-OS)consensus statement[J]. Eur Heart J, 2022, 43(4):280.
[2] GIRAUD E L, FERRIER K R M, LANKHEET NAG, et al. The QT interval prolongation potential of anticancer and supportive drugs:a comprehensive overview[J]. Lancet Oncol, 2022, 23(9):e406.
[3] ALEXANDRE J, MOSLEHI J J, BERSELL K R, et al.Anticancer drug-induced cardiac rhythm disorders:Current knowledge and basic underlying mechanisms[J]. Pharmacol Ther, 2018, 189:89.
[4] HERRMANN J. Adverse cardiac effects of cancer therapies:cardiotoxicity and arrhythmia[J]. Nat Rev Cardiol, 2020, 17(8):474.
[5] DUAN J, TAO J, ZHAI M, et al. Anticancer drugs-related QTc prolongation, torsade de pointes and sudden death:current evidence and future research perspectives[J].Oncotarget, 2018, 9(39):25738.
[6] CHU W, LI C, QU X, et al. Arsenic-induced interstitial myocardial fibrosis reveals a new insight into drug-induced long QT syndrome[J]. Cardiovasc Res, 2012, 96(1):90.
[7] DROLET B, SIMARD C, RODEN D M. Unusual effects of a QT-prolonging drug, arsenic trioxide, on cardiac potassium currents[J]. Circulation, 2004, 109(1):26.
[8] SUN H L, CHU W F, DONG D L, et al. Cholinemodulated arsenic trioxide-induced prolongation of cardiac repolarization in Guinea pig[J]. Basic Clin Pharmacol Toxicol, 2006, 98(4):381.
[9] HANCOX J C, CAVES R E, CHOISY S C, et al. QT interval prolongation and torsades de pointes with oxaliplatin[J]. Ther Adv Drug Saf, 2016, 7(6):261.
[10] DUCROQ J, MOHA O U MAATI H, GUILBOT S, et al.Dexrazoxane protects the heart from acute doxorubicininduced QT prolongation:a key role for I(Ks)[J]. Br J Pharmacol, 2010, 159(1):93.
[11] RODEN D M. A current understanding of drug-induced QT prolongation and its implications for anticancer therapy[J].Cardiovasc Res, 2019, 115(5):895.
[12] YANG T, CHUN Y W, STROUD D M, et al. Screening for acute IKr block is insufficient to detect torsades de pointes liability:role of late sodium current[J]. Circulation, 2014,130(3):224.
[13] HAWRYSZKO M, S?AWI?SKI G, TOMASIK B, et al.Cardiac arrhythmias in patients treated for lung cancer:A review[J]. Cancers(Basel), 2023, 15(24):5723.
[14] LAMPSON B L, YU L, GLYNN R J, et al. Ventricular arrhythmias and sudden death in patients taking ibrutinib[J].Blood, 2017, 129(18):2581.
[15] TOMCSáNYI J, NéNYEI Z, MáTRAI Z, et al.Ibrutinib, an approved tyrosine kinase inhibitor as a potential cause of recurrent polymorphic ventricular tachycardia[J].JACC Clin Electrophysiol, 2016, 2(7):847.
[16] MIR H, ALHUSSEIN M, ALRASHIDI S, et al. Cardiac complications associated with checkpoint inhibition:A systematic review of the literature in an important emerging area[J]. Can J Cardiol, 2018, 34(8):1059.
[17] LARSEN R L, JAKACKI R I, VETTER V L, et al.Electrocardiographic changes and arrhythmias after cancer therapy in children and young adults[J]. Am J Cardiol, 1992,70(1):73.
[18] PORTA-SáNCHEZ A, GILBERT C, SPEARS D, et al.Incidence, diagnosis, and management of QT prolongation induced by cancer therapies:A systematic review[J]. J Am Heart Assoc, 2017, 6(12):e007724.
[19] LYON A R, LóPEZ-FERNáNDEZ T, COUCH L S, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association(EHA), the European Society for Therapeutic Radiology and Oncology(ESTRO)and the International Cardio-Oncology Society(IC-OS)[J]. Eur Heart J, 2022, 43(41):4229.
[20] PANIKKATH R, REINIER K, UY-EVANADO A, et al.Prolonged Tpeak-to-Tend interval on the resting ECG is associated with increased risk of sudden cardiac death[J]. Circ Arrhythm Electrophysiol, 2011, 4(4):441.
[21] VERRIER R L, KLINGENHEBEN T, MALIK M, et al.Microvolt T-wave alternans physiological basis, methods of measurement, and clinical utility-consensus guideline by International Society for Holter and Noninvasive Electrocardiology[J]. J Am Coll Cardiol, 2011, 58(13):1309.
[22] LU H R, YAN G X, GALLACHER D J. A new biomarkerindex of cardiac electrophysiological balance(iCEB)-plays an important role in drug-induced cardiac arrhythmias:beyond QT-prolongation and torsades de pointes(TdPs)[J]. J Pharmacol Toxicol Methods, 2013, 68(2):250.
[23] WASSERMAN R L, SEGER D L, AMATO M G, et al. A calculated risk:Evaluation of QTc drug-drug interaction(DDI)clinical decision support(CDS)alerts and performance of the tisdale Risk score calculator[J]. Drug Saf, 2024, 47(12):1235.
[24] SIMON S T, LIN M, TRINKLEY K E, et al. A polygenic risk score for the QT interval is an independent predictor of drug-induced QT prolongation[J]. PLoS One, 2024, 19(6):e0303261.
[25] ZHANG H, TARABANIS C, JETHANI N, et al. QTNet:Predicting drug-induced QT prolongation with artificial intelligence-enabled electrocardiograms[J]. JACC Clin Electrophysiol, 2024, 10(5):956.
[26] LEHTONEN A, FODSTAD H, LAITINEN-FORSBLOM P, et al. Further evidence of inherited long QT syndrome gene mutations in antiarrhythmic drug-associated torsades de pointes[J]. Heart Rhythm, 2007, 4(5):603.
[27] BEHR E R, RODEN D. Drug-induced arrhythmia:pharmacogenomic prescribing?[J]. Eur Heart J, 2013, 34(2):89.
基本信息:
DOI:10.13333/j.cnki.cjcpe.2025.05.001
中图分类号:R730.5;R541.7
引用信息:
[1]陶婧雯,段嘉霖,林立.抗肿瘤治疗相关室性心律失常的监测与治疗[J].中国心脏起搏与心电生理杂志,2025,39(05):377-380.DOI:10.13333/j.cnki.cjcpe.2025.05.001.