无创性影像学技术评估肿瘤治疗相关心血管毒性的临床应用指南(2023版)

Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity(2023 edition)

肿瘤治疗所致心血管损伤已经成为肿瘤幸存者的重要死亡原因。随着对肿瘤患者合并心血管疾病和肿瘤治疗相关心血管毒性(CTR-CVT)认识的深入,无创性影像学检查在CTR-CVT的临床风险分层、早期诊治、监测和随访过程中发挥了重要作用。近年来肿瘤心脏病学领域诊断及治疗策略不断更新,国内外已发表一些肿瘤心脏病学的相关指南和专家共识,但是目前缺乏影像学检查技术在肿瘤心脏病学临床应用中的系统指导性文件。因此,中国抗癌协会整合肿瘤心脏病学分会、中华医学会超声医学分会、中国超声心动图学会组织专家结合最新循证医学证据,制订了《无创性影像学技术评估肿瘤治疗相关心血管毒性的临床应用指南》。本指南在系统评估国内外近年来发表的肿瘤心脏病学领域指南和最新循证医学研究证据的基础上,结合基于国人循证医学研究的数据,提出了CTR-CVT的无创性影像学检查方法和监测策略,旨在进一步规范和指导我国肿瘤心脏病学领域多学科医师的临床实践。

Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in tumor patients,noninvasive imaging technologies play pivotal roles in the risk stratification,early diagnosis,monitoring and follow-up for CTR-CVT.In recent years,the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies,with several pertinent guidelines and expert consensus documents issued in China and abroad.However,there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology.Therefore,the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology,the Ultrasound Branch of the Chinese Medical Association,and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity".Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad,and in conjunction with data derived from evidence-based medical research in China,this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT,aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.