Zusammenfassung
Durch eine fortwährende Weiterentwicklung der modernen Krebstherapie können jedes Jahr mehr Patienten mit Tumorerkrankung geheilt werden. Da es bei vielen Patienten jedoch kardiovaskuläre Probleme vor, während und nach ihrer Tumorbehandlung gibt, wird die Kardioonkologie immer wichtiger. Es gibt viele Therapien, die eine Kardiotoxizität verursachen können, so etwa Chemo‑, Immun‑, Antikörper- und Strahlentherapien. Bleiben diese unerkannt, kann der Patient unter anderem eine Herzinsuffizienz oder eine schwerwiegende Schädigung der Herzklappen entwickeln. Für Kardiologen und Onkologen ist das breite Spektrum der kardiovaskulären Komorbiditäten eine immense Herausforderung geworden. Die Kardioonkologie befasst sich daneben auch mit den Effekten der Tumorerkrankung selbst auf das kardiovaskuläre System. Neue Forschungsergebnisse weisen darauf hin, dass es auch direkte negative Einflüsse des Tumors auf das Herz gibt, die durch Botenstoffe vermittelt werden. Es ist daher wichtig zu verstehen, welche Patienten mit Tumorerkrankung ein erhöhtes kardiovaskuläres Risiko haben. So können langfristig neue Therapieansätze entwickelt werden, um Mobilität zu erhalten und die Prognose der Patienten zu verbessern.
Abstract
As a result of the continuous development of modern cancer treatment, more cancer patients can be cured every year. However, since many patients experience cardiovascular problems before, during and after their cancer treatment, cardio-oncology is becoming increasingly important. Numerous therapies can cause cardiotoxicity, such as chemotherapy, immunotherapy, antibody therapy and radiotherapy. If these remain undetected, the patient may develop, e.g. heart failure or severe heart valve damage. The broad spectrum of cardiovascular comorbidities has become an immense challenge for cardiologists and oncologists. Cardio-oncology also deals with the effects that cancer has on the cardiovascular system. New research indicates that the tumor itself also has direct negative effects on the heart, mediated by messenger substances. Therefore, it is important to understand which cancer patients are at increased cardiovascular risk, thereby enabling the development of new therapeutic approaches in the long term to maintain mobility and improve patient prognosis.
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M.S. Anker hat Gelder für Beratertätigkeiten von Servier außerhalb der aktuellen Arbeit erhalten. S. von Haehling hat Beratungs- und/oder Vortragshonorare erhalten von Bayer, Boehringer Ingelheim, BRAHMS/Thermo Fisher, Chugai Pharma, Grünenthal, Helsinn, Novartis, Pharmacosmos, Respicardia, Roche, Servier und Vifor. Seine Arbeitsgruppe erhält Forschungsunterstützung vom Deutschen Zentrum für Herz-Kreislauf-Forschung (DZHK), der Innovative Medicines Initiative – Joint Undertaking (IMI–JU 115621) sowie von Boehringer Ingelheim und Amgen. S. Hadzibegovic gibt an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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G. Hasenfuß, Göttingen
S. von Haehling, Göttingen
M.S. Anker und S. Hadzibegovic teilen sich die Erstautorenschaft.
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Anker, M.S., Hadzibegovic, S. & von Haehling, S. Effekte des Tumors auf Herz und Kreislauf. Internist 61, 1120–1124 (2020). https://doi.org/10.1007/s00108-020-00887-w
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DOI: https://doi.org/10.1007/s00108-020-00887-w