Abstract：
In recent years, important advances have been made in the field of Cardio-Oncology. The 2022 ESC Guidelines on Cardio-Oncology proposed a baseline cardiovascular risk stratification for cancer patients and preventive strategies in patients at high and very-high risk of cardiotoxicity. Cardiovascular toxic effects of anti-cancer drugs are being extensively studied; surveillance programs have been proposed, based on the baseline cardiovascular risk. On the other hand, there is little data on Cardio-Oncological management of patients at high and very-high cardiovascular risk with previous cardiovascular diseases. For example, little is known about management of cancer patients with heart failure with reduced ejection fraction (HFrEF), patients with a recent myocardial infarction or other cardiovascular diseases; when to resume anti-cancer drugs after a cardiovascular toxic event. Collaboration between Cardiologists and Oncologists and multidisciplinary team evaluations are certainly essential to decide the best therapeutic strategy for cancer patients, to treat cancer while saving the heart. Therefore, in the present review, we attempt to provide a useful guide to clinicians in treating patients with high and very-high risk of cardiotoxicity by enucleating main questions and answering them based on the evidence available as well as expert opinion and our clinical experience.
摘要：
近年来,心血管肿瘤领域取得了重要进展。2022年ESC心血管肿瘤学指南提出了癌症患者的基线心血管风险分层以及心脏毒性高风险患者的预防策略。抗癌药物的心血管毒性作用正在被广泛研究；已经提出了监测方案，基于基线心血管风险。另一方面,关于既往心血管疾病的高和极高心血管风险患者的心血管肿瘤学管理的数据很少.例如,关于射血分数降低的心力衰竭（HFrEF）的癌症患者的管理知之甚少，近期有心肌梗死或其他心血管疾病的患者；心血管毒性事件后何时恢复抗癌药物。心脏病学家和肿瘤学家之间的合作以及多学科团队评估对于决定癌症患者的最佳治疗策略至关重要。在拯救心脏的同时治疗癌症。因此,在本次审查中，我们试图通过摘除主要问题并根据现有证据,专家意见和我们的临床经验回答这些问题,为临床医师治疗高和极高心脏毒性风险患者提供有用的指导.
