293 Ch 292. Cardio-Oncology — Cancer Therapy-Related Cardiovascular Toxicity (CTR-CVT)

Cardio-oncology 是 2010s-2020s 興起的次專科，因癌症治療存活率改善但 CV 副作用顯著；主要藥物族群毒性：(1) anthracyclines (doxorubicin) — dose-dependent LV dysfunction; (2) trastuzumab + HER2 inhibitors — reversible LV dysfunction; (3) TKIs (sunitinib, sorafenib) — HTN, LV dysfunction; (4) VEGF inhibitors (bevacizumab) — HTN, arterial thromboembolism, proteinuria; (5) BCR-ABL TKIs (ponatinib, nilotinib) — arterial thrombosis, IHD; (6) immune checkpoint inhibitors (ICI) — myocarditis (rare but severe); (7) proteasome inhibitors (carfilzomib) — HF; (8) chest radiation — IHD, pericarditis, valvular, conduction; baseline + serial monitoring (echo, troponin, BNP) per 2022 ESC Cardio-Oncology Guideline (CARDIOTOX risk stratification); cardioprotection：dexrazoxane (anthracycline); ARNI/ACEi + β-blocker + SGLT2i for primary + secondary prevention；ICI myocarditis = high-dose steroid + stop ICI + 2nd agent (infliximab, abatacept, JAK inhibitors)。