Cancer may cause changes to the heart before treatment

某些类型的癌症可能会改变心脏的外观和功能, 根据一项新的研究，该研究分析了癌症治疗前人们的心脏.

An estimated 1.预计今年美国将有900万人被诊断患有癌症, according to the National Cancer Institute. 有癌症史的人患心血管疾病的风险更大:老年乳腺癌幸存者, for example, are most likely to die from cardiovascular disease, not breast cancer. 癌症和心脏病也有一些共同的风险因素，包括肥胖和吸烟.

但研究人员仍在试图弄清楚，与可能对心脏有毒的普通治疗相比，有多少风险来自癌症本身.

了解癌症患者化疗前的心脏健康基线, 加拿大的研究人员招募了381名乳腺癌或淋巴瘤患者和102名没有癌症或心血管疾病的人. 两组人都接受了心脏核磁共振扫描，以创建心脏跳动的3D模型和心肌炎症图. 它使研究人员能够观察心脏的外观和功能.

Compared to the control group, people with cancer had reduced volume of the left ventricle, 为身体其他部位提供加氧血液的腔体. That resulted in it pumping less blood per heartbeat. 这些模型还显示出压力升高，这是一种衡量心脏工作强度的指标. 最后，癌症患者的心脏出现了炎症的迹象. The findings appeared Wednesday in the Journal of the American Heart Association.

“我们提供的证据表明，癌症本身确实会改变心肌的健康," said senior author Dr. James A. White, 利宾心血管研究所斯蒂芬森心血管成像中心主任. 他还是加拿大阿尔伯塔省卡尔加里大学的医学教授.

怀特说，到目前为止，大部分研究都集中在试图了解化疗对心血管系统的影响. Chemotherapy works by killing fast-growing cancer cells, but these treatments can damage healthy heart cells, too. Chemo drugs like anthracyclines, used to treat breast cancer and lymphoma, have side effects that include left ventricle dysfunction, heart failure and inflammation. 其他特定的癌症药物和对胸部的放射治疗也可以 affect the heart.

尽管目前尚不清楚未纳入研究的其他类型癌症患者是否会出现类似的心脏变化, 怀特说，研究结果强调了在治疗开始前了解新诊断出癌症患者的心脏健康状况.

“在癌症治疗之前，心脏处于正常健康状态的基本假设可能并不完全正确," White said. “患癌症本身似乎会改变心血管系统的行为."

As for how cancer might actually cause these changes, he said systemic inflammation likely plays a role. As cancer activates the immune system, the immune response triggers inflammation, which in turn may affect the cardiovascular system.

另一个大问题是这些心脏变化能持续多久. Tochukwu M. 芝加哥拉什大学医学中心的心脏肿瘤科主任Okwuosa说.

"Once we treat the cancer, will they go away? If so, I wouldn't expect any long-term consequences," said Okwuosa, who was not involved in the study. "Or, 这些异常是否意味着这些患者在未来更容易出现心血管疾病? That remains to be seen."

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