许多心血管疾病的特点是舒张功能障碍，这与更差的临床结果相关，例如总体死亡率和心力衰竭 (HF) 住院治疗。舒张功能障碍也被怀疑是癌症药物引起的心脏毒性的早期表现，大部分信息来自接受蒽环类药物治疗的患者；然而，对于接受蒽环类药物治疗的患者，舒张功能障碍的预后影响仍未得到充分探索或被忽视。本文根据癌症幸存者心力衰竭的发生率和表型，对蒽环类药物相关舒张功能障碍的分子、病理生理学和诊断方面进行了综述。我们描述了舒张功能障碍向心力衰竭发展的轨迹受到一系列患者或治疗相关因素的影响，例如合并症和接触其他心脏毒性药物或治疗，但也受到治疗舒张功能障碍的前瞻性新机会的影响。以研究为导向的多维方法对患者监测或治疗的重要性在似乎是一种独特的病理生理学实体的框架内进行了讨论，该实体在蒽环类药物治疗过程中早期发展并随着时间的推移逐渐恶化。版权所有 © 2024。由爱思唯尔公司出版。

Many cardiovascular diseases are characterized by diastolic dysfunction, which associates with worse clinical outcomes like overall mortality and hospitalization for heart failure (HF). Diastolic dysfunction has also been suspected to represent an early manifestation of cardiotoxicity induced by cancer drugs, with most of the information deriving from patients treated with anthracyclines; however, the prognostic implications of diastolic dysfunction in the anthracycline-treated patient have remained poorly explored or neglected. Here the molecular, pathophysiologic and diagnostic aspects of anthracycline-related diastolic dysfunction are reviewed in the light of HF incidence and phenotype in cancer survivors. We describe that the trajectories of diastolic dysfunction toward HF are influenced by a constellation of patient- or treatment- related factors, such as comorbidities and exposure to other cardiotoxic drugs or treatments, but also by prospective novel opportunities to treat diastolic dysfunction. The importance of a research-oriented multidimensional approach to patient surveillance or treatment is discussed within the framework of what appears to be a distinct pathophysiologic entity that develops early during anthracycline treatment and gradually worsens over the years.Copyright © 2024. Published by Elsevier Inc.